To ask if any of you can give me medical advice??

[fluffandnonsense]

I'm 25 weeks pregnant and since about 14 weeks I've had an infection down below. My doctors have been bloody useless and I've been back and forth having swabs etc. The swabs show I have some thrush and strep B.

I've had two courses of Erythromycin and numerous thrush treatments. Still no better. I saw my midwife on Thursday and she said under no uncertain terms I need to go back to the doctor and demand they change my treatment. I have leukocytes in my urine and she said if this infection carries on untreated it could cause irritation and premature birth.

I made an appt and explained all this, on the system the infection is showing as sensitive to Clarythromicin, so asked if I could have this. The Dr was very rude to me and dismissive of what the midwife has said. He said as I'm allergic to Penicillin he can only give me Erythromicin. He said the other one is not approved for use in pregnant women as its not ethical to test it, as most medications are. I said well I can't go on like this and he said no if you don't get it sorted the baby could contract meningitis during labour!! So basically he gave me the choice of taking Clarythromicin and taking the responsibility myself for any problems it may cause or do nothing and risk my baby being born with meningitis!

I took the antibiotics. (But not started the course yet)

Since then I have been in touch with a Pharmacist who has said
under no uncertain terms I should not take the antibiotics.

His suggestion is that I should take a low dose of Penicillin and see if I have a reaction (as I did when I was 4 years old, I came out in a rash).

If I don't have a reaction I can have a full blown course and get this infection sorted, if I do come out in a rash he said it shouldn't cause any problems for the baby at all.

I'm just so confused, every option has risks but no one seems willing to tell me the best choice in their medical opinion! I'm not a doctor, I have no idea what to do for the best.

What on earth do I do?

[Doinmummy]

I thought antibiotics caused thrush too. Have you tried live yoghurt on a tampon?

[fluffandnonsense]

I've tried all the usual thrush treatments. None have worked. It has been so bad before now that I haven't been able to leave the house I've been in agony :/

[fluffandnonsense]

They said something about treating the strep B as it is currently active?

[Laurel1979]

I would strongly recommend going to the GUM clinic, they are usually very good at dealing with cases of recurrent thrush etc. If you weren't pregnant there would be a large choice of different treatments you could try, but unfortunately most are not licensed for pregnancy, hence it can be difficult to prescribe appropriately. Every area has different ways of referring to them, your GP should be able to let you know how to get an appt. Many people don't like the thought of going as they think its for people with STD's but actually they do a lot of other things too!

[Laurel1979]

PS Was the Clarithromycin sensitivity based on a vaginal swab? Did a urine culture grow anything? In terms of the Group B Strep, regardless of whether it is treated during the pregnancy or not, the fact that you have habit means you should automatically receive intrapartum antibiotics to prevent complications such as meningitis. Obviously that doesn't help you with your symptoms now though! What does your midwife want your GP to do out of curiosity? Prescribe unlicensed antibiotics and potentially be held responsible for any complications?
Really hope you get it sorted out soon, sounds like its dragged on for a while....

[fluffandnonsense]

Yes it grew from the swab and showed sensitivity to Clarymthromicin. I really don't know what the midwife is wanting me to do. I'm tempted to leave a message for her tomorrow to call me. What about the penicillin route?

[Laurel1979]

I'd be wary of taking it tbh if you've already had a rash, as a GP there's no way I'd prescribe it in anyone with a known allergy. One option might be to get a blood test to check if you definitely are allergic. Another could be to ask either the midwife or GP to ask the local obstetrician for advice, I think that's what I'd do if all the licensed prescribable treatments have failed. Good luck with getting it sorted out.

[toldmywrath]

I'd be very reluctant to try penicillin. I had a mild allergic reaction when young (rash) & was told I was allergic. I then had a blood test for allergy & was told I wasn't (I had persistent sore throat & GP wanted to give me penicillin) Anyway, I had one course-no problem. Several years later I was prescribed more Penicillin-disaster! I had a severe reaction: whole body swelled including tongue & throat affecting airways. Rash was excrutiating-the itch & heat drove me mad-all over & I mean all over rash which could not be relieved at all. Frightening drop in blood pressure & I was put on high dose steroids to combat all this.
Very sorry to hear about your mixed messages & the symptons of thrush can be very debilitating. Hope someone comes up with an answer & soon.

[sayithowitis]

Not a medic bit I had an allergic reaction to penicillin as a teenager ans was told at the time I must NEVER have penicillin again. I am now over 50 and no doctor has ever suggested it for me since. I would not risk it for myself ans definitely not if I was pregnant. Sorry you are suffering - I hope it gets properly sorted for you soon.

[toldmywrath]

Oh & the reaction to penicillin happened after I had just finished the course (i.e. not with the first tablet) I had no idea it could happen that way, but this is what happened & what my GP said was the cause.

[Laurel1979]

I also think it would be worthwhile to try a course of Azithromycin, it's widely used in pregnancy and quite similar coverage to Penicillin without the risks of allergy

[Canthisonebeused]

It is best not be treating the strep b just yet I believe. I thought it was optimum to treated at 35 to 38 weeks. I'm allergic penicillin and was stub b positive during labour. I was iv antibiotics during labour but they didn't catch it on time I have iv antibiotics after dd was born too. I'm not sure what they were tbh but there were no complications or concerns of penicillin so I assume the yreatment isn't penicillin based anyway. I may be wrong though.

As antibiotics cause thrush I would imagine they should focus on treating this just now or treat the ruin infection and then the thrush and treat the strep b as would be normal.

[ColderThanAWitchsTitty]

I had antibiotics for strep b during labor. Not before

[fluffandnonsense]

So I shouldn't even be having antibiotics beforehand?

[peppermintfondant]

I think you have been given some poor advice OP. I'm a GP and have had Gp B strep detected in nearly all of my pregnancies. All of my children have been absolutely fine. The scaremongering that appears to have happened is very unhelpful.

Firstly, Group B Strep is not 'an infection'. It is a bacteria that is frequently found to colonise the vagina in a significant percentage of normal women. Under normal circumstances, without symptoms, it wouldn't be treated. In pregnancy, there is an increased risk of premature labour and a potential for the baby to be infected which is why there is a degree of anxiety associated with it.

Your midwife should be managing this. There is no need for you to be going backwards and forwards to the GP. She should be explaining things to you properly and communicating with your GP.
Generally, Gp B Strep is not treated until labour and this is done with intravenous antibiotics.
Some Consultants, in some units may decide to give patients a course of penicillin (or equivalent) at a later stage of pregnancy with a week or two of antibiotics if the Gp B Strep has been found in your urine (not just on a vaginal swab- not clear if this is the case with you) I'm not sure there is much evidence for this but some Obstetricians do it. Also, some units (probably the majority) suggest keeping the baby under observation for the 48 hours after birth and may want to take swabs, sometimes even blood tests. I personally declined all this for my babies and took them home but this was my personal decision and I wouldn't encourage you one way or the other.

Firstly, try not to worry. Lots of women have this bacteria detected and a v small percentage have a baby born with the infection.
Speak to your midwife on Monday and ask her to be clear about your hospital's policy on Gp B Strep (ie under exactly what circumstances you need to be treated). If she is vague or unclear, ask her to speak to your named Consultant to check or to speak to him/ her yourself.
You can then make an informed decision about whether to take antibiotics now or whether to just wait until labour.
The thrush is a separate and less complicated issue which I'm sure your midwife/ GP can manage without any trouble.

[fluffandnonsense]

Thanks for your reply peppermint, that's really helpful. I feel like I'm being treated by a bunch of idiots, no one answers my questions properly and I feel like I'm going rind in bloody circles.

I'm not under a consultant, should I be? I've been told I may or may not need antibiotics during labour and that they will swab me closer to delivery.

My symptoms are sore and itchy down below, no huge amount of discharge and no typical thrush issues, 'cottage cheese' etc. at the moment. It's been fine for about a week or so but then suddenly it flares up and I can't stop scratching.

There attitude is the antibiotics are to get rid of the strep b before I go into labour?

[SeaSickSal]

I had problems with recurrent UTIs in pregnancy and was put under a consultant. Ask to be referred to one, can't do any harm.

[whatever5]

I wouldn't try penicillin if I was you. Although many people think they're allergic to it when they're actually not, I don't think pregnancy is the time to test it! I also would be reluctant to take clarithromycin unless advised to by an obstetrician.

The main problem with strep B is that it can infect the baby during childbirth. It very rarely causes premature birth so I think that midwife is scaring you unnecessarily to suggest this. Although you should get it treated before you give birth it isn't an emergency.

If I was you, I would switch to consultant led care and see what they recommend. Your GP sounds really unhelpful.

[whatever5]

I should clarify, when I say it isn't an emergency I mean that you don't have to get it treated immediately if you are only 25 weeks pregnant. I think you have time to get some better advice.

[troutchicken]

Sorry , I don't have experience of your current predicament, however I have experienced months of terrible 'thrush'.

After months of different hospital departments and various indignities my thrush turned out to be a skin problem, a sort of excema, which was cleared up with a one tube of basic excema type treatment cream! I was getting frequent thrush on top of swollen sore itchy bits ( sometimes had to leave work it was that bad) simply because flora and fauna wasn't happy.

Just a thought that the thrush may have a different cause.....

[ColderThanAWitchsTitty]

My symptoms are sore and itchy down below, no huge amount of discharge and no typical thrush issues, 'cottage cheese' etc. at the moment. It's been fine for about a week or so but then suddenly it flares up and I can't stop scratching.

I had that the whole last trimester of my last pregnancy.. I bought some anti itch vag cream it worked mostly. It stopped pretty much the second I had the baby. If I remember correctly it can be a normal pregnancy symptom to do with veins or vulva engorgement and blood flow. Nothing related to the group B strep.


It's a proper fucker though.

[peppermintfondant]

fluffandnonsense- you will still have a nominated consultant even if you are midwife led care, which most people are.

Treating the strep B at some stage of pregnancy may eradicate it but it may well come back as strep B is carried most of the time by some women. For this reason and others, a lot of Obstetricians don't treat it and simply give IV antibiotics in labour. In my experience, the majority (all that I have come across) will treat in labour with IV antibiotics if Gp B strep has been detected at any point in the current pregnancy, regardless of whether you have had antibiotics earlier.

As I said, units do vary so check the policy with your midwife. Ideally, ask for it in writing. Then you can make a decision about whether or not to take the antibiotics.

The itching you are experiencing may be thrush or, as another poster mentioned, may just be the engorgement/ venous dilatation that occurs in pregnancy.

[AnyoneforTurps]

In addition to the excellent advice from peppermint, don't worry about the leucocytes (white cells) in your urine. This is normal in pregnancy - your midwife really should know that and should not be making you needlessly anxious.

If your urine sample has not grown any bacteria, you do not have a UTI and do not need treatment.