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Have any of you used IM penicillin before labor for GBS?

post #1 of 7
Thread Starter 

I'm asking because I had GBS in my urine (very low levels - not enough to qualify as bacteriuria, according to my OB practice's guidelines) at the 10 week urinalysis. It was not a clean catch by any means, but it concerns me that it was in my urine anyway, since I know that generally indicates heavy colonization. I have decided I will opt for the penicillin during labor IF there is time for it, but I'm guessing there won't be, since my last labor was under an hour, so I was wondering if any of you have tried the penicillin injection at 37 or 38 weeks. I've read about that and just wanted to know if anyone actually does it. Apparently it's not been extremely well-studied, but of course I don't really have many options, under the circumstances. It might be the best I can do, since general healthy living, probiotics, etc. seem not to have made any difference at all in my GBS status. I was + last time, but just at the normal rectovaginal culture, so I imagine I'm a permanent carrier at this point. I will probably try the hibiclens, just because it's probably better than nothing, but given the GBS in urine, I'd like to have something else. My midwife can do the IM injection (I do mw and OB prenatal care, but will deliver with a midwife). Has anyone ever done it? What was your protocol?

post #2 of 7

unfortunately the research that is available does not support the use of antibiotics for GBS positive moms prior to the beginning of labour. it does not seem to change the status at the time of birth. if you cannot get a dose in before your baby is born, then you can watch for signs of infection in your baby instead. good luck! i'm curious to know what you decide to do.

post #3 of 7
Thread Starter 

What I've read is that the research does not support oral or IV antibiotic use, since they basically stop working within hours of the last dose. However, a couple of studies have shown that IM penicillin is longer acting (I guess because it takes time to work its way out of the muscle and through the system?). It has to be given within 2 or 3 weeks of birth (I can't remember which or how much, but will look it up if I decide to try it) in order to be effective, and it was less effective at eliminating GBS than the IV, but more effective than oral abx or nothing. I was just wondering if I'd be the only person on the planet to opt for it, lol. In one of the studies I read, they specifically mentioned it as a good option for GBS+ women with a history of precipitous labor. I know that the risk is considered lower in a fast labor anyway, but in both my previous labors, my water has broken at the beginning of labor or before labor, so it's not like it's only breaking when the baby's crowning or anything - there's still an hour or more of exposure there. I'm just hoping that if I have a fast labor, I get a baby born in the caul. :)

post #4 of 7

If you get on to Midwifery Today's Facebook page there is a question near the top about gbs and one comment linked to a pubmed study comparing penicilian use to chlorhexidine use and found the results with chlorhexidine flushes to be very good. This was specific to labor, but I wonder if you could start doing them at home when you get close to term and continue with them into labor so that they had ongoing for awhile if labor goes real fast for you again.

post #5 of 7
Thread Starter 

Thanks! I'll look.

post #6 of 7
post #7 of 7

This study actually compares chlorhexidine washes with ampicillin, which is known to be less effective than penicillin g at killing GBS.

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