QuestionPrescription
QuestionComment
where do i find information on group b strep and the antibiotic of choice on the BNF?

42096
QuestionComment
you type 'group b streptococcal' on the bnf and it will come up as benzylpenicillin
44134
User
subscriber
Thermoregulator Tachycardia
User
subscriber
Thermoregulator Tachycardia
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
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3631
Treating intrapartum group B streptococcus infection
Topic
131
Obstetrics & Gynaecology/Paediatrics
## Drug choice feedback

This patient has a group B streptococcus infection. Streptococcus agalactiae is the most common pathogen that belongs to the Group B streptococcus family. Treatment of Group B strep during labour is with IV benzylpenicillin, initially this should be a 3g IV infusion followed by 1.5g IV infusions every 4 hours until delivery.

## Dose/Route/Frequency/Duration feedback

The following prescription is appropriate to treat this patient's group B streptococcus infection:

- Benzylpenicillin 3g IV once-off, and then 1.2g every 4 hours
10102
PrescriptionAnswer
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3 g
PrescribeAnswerData
benzylpenicillin sodium 600 mg injection
PrescribeAnswerData
Once-off
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once only (STAT)
PrescribeAnswerData
intravenous (IV)
PrescriptionAnswer
PrescribeAnswerData
3 g
PrescribeAnswerData
benzylpenicillin sodium 1.2 g injection
PrescribeAnswerData
Once-off
PrescribeAnswerData
once only (STAT)
PrescribeAnswerData
intravenous (IV)
Case Presentation: A 33-year-old 37 week pregnant woman attends the maternity ward as she has gone into labour.


## PH
Nil.

## DH
Nil. NKDA.

## On examination

Patient comfortable at rest. No evidence of any oedema or the face or peripheral areas.

Symphysial-fundal height is 37cm, the position of the foetus is a longitudinal lie with cephalic palpation.

Temperature 37.3°C, HR 88, RR 16, BP 126/78, O<sub>2</sub> 98% RA, GCS 15, Weight 85kg

## Investigations

FBC: Hb 124, WCC 4.8, Plts 253 x 10^9

CRP 2

U&Es: Na 141, K 4.3, Ur 5.0, Cr 64, eGFR >90mL/min/1.73m<sup>2</sup>

Ca2+ (adjusted): 2.4

Mg2+: 0.8

Phosphate: 0.82

LFTs: ALP 31, ALT 23, bilirubin 12

TFTs: TSH 1.3, T4 11, T3 8

MSU: Streptococcus agalactiae

## Prescribing Request

Write a prescription for one drug that is most appropriate to give while she is in labour.