“Here’s where I'm reluctant”, admits Dr. Mansfield. “You have all heard about the excessive use of antibiotics and the harmful consequences they could have on the development of the “super bacteria”, a bacteria that does not respond to any antibiotics. Furthermore, we currently don’t have the enough retrospect to know the influence antibiotics have on babies, but carefulness is always best.”
“Don’t tell me about it. My uncle is in the hospital and suffers from Hard Clostridium” adds Lydia with a severe look on her face. “It’s very serious, and except the good treatments that are keeping him going, none of the antibiotics are working. The whole family is hoping he gets better.”
“Hard Clostridium is a new type of bacteria that has become resistant to antibiotics. There are many other types, like E Coli, that affect young children. As a matter of fact, the amoxicillin that was once used to prevent the Streptococcus B infections is no longer our first choice because a resisting bacterium have developed.”
“So it may not be ideal to expose an unborn baby to antibiotics as useful as Penicillin…” mumbles Paul.
“Exactly”, answers Dr. Mansfield. “You will quickly realize that today’s medicine is far from having the perfect solution for every problem. That’s something I understood well before finishing med school. I didn’t mention that the mother could also be allergic to penicillin, and if that’s the case, she could end up with a severe allergic reaction, which means an anaphylactic shock.
“Phew” says Paul in a sigh of relief.
“And”, continues the doctor, “for the antibiotics to be effective in the baby’s placenta, the mother must have received her dose of penicillin four hours before delivering”.
“What would they do with women who deliver in less than two hours?” asks Lydia.
“You can always refuse the vaginal culture and decide to go ahead with treatment if some of the risk factors explained before are present. If a woman hasn’t received antibiotics and we know she is positive to Streptococcus B, the baby will be considered “at risk” and will be monitored closely by the paediatrician who may decide to do blood tests and a hemoculture. While waiting for the results, which can take up to 48 hours, the paediatrician could decide to give the baby intravenous antibiotics if he shows signs of infection. The doctor can’t take that chance”.
“Can you sum up the facts, Dr. Mansfield?” asks Lydia while taking notes.
Dr. Mansfield smiles and starts:
- Almost 30% of women carry the Streptococcus B vaginal virus.
- The recommendations state that treatment should be given during labour to any woman who has a positive screening test.
- Some women had a negative screening test and their babies developed a Streptococcus B infection. Treating every woman with a positive screening test does not prevent all cases of infection.
- I completely agree with treating patients depending on the risk factors talked about before… Knowing it doesn’t prevent all cases either.
- Statistics show that we need to treat 200 women to prevent one case of baby’s Streptococcus B infection, because the infection is relatively rare. We are not statistics, and when a baby is infected, it’s always a tragic event.
- A warning has been put out in the medical society to prevent the excessive use of antibiotics, because it is now more common to see really resistant bacteria, therefore, potentially very dangerous.
“Many articles exist on the subject. You must be careful because many of them are distorted and dramatize the situation, and others seem to be opposed to everything without actually taking the facts into account."
