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1.  Patterns of Antibiotic Resistance Among Group B Streptococcus Isolates: 2001–2004 
The objectives were to determine the prevalence of group B streptococcus (GBS) and to characterize antibiotic resistance patterns. All pregnant women presenting to the triage units at two urban hospitals during three intervals from 2001 to 2004 were included. Each interval lasted approximately four weeks. Swabs were inoculated into selective broth and cultured on tryptic soy agar with 5% sheep blood. GBS was identified using the StrepTex latex agglutination system. GBS positive cultures were tested for their resistance to ampicillin, erythromycin, clindamycin, and cefazolin. GBS was isolated from 154 (12.2%) of 1264 swabs collected during the study period. African-American women were more likely to be colonized with GBS than Caucasians and Hispanics. Resistance to routinely administered antibiotics was common, but there were no statistically significant increases in resistance to antibiotics over the study period. Ongoing surveillance of antibiotic resistance patterns is important in determining optimal prophylaxis and therapy.
PMCID: PMC1581469  PMID: 17093353
2.  Acyclovir Suppression to Prevent Clinical Recurrences at Delivery After First Episode Genital Herpes in Pregnancy: An Open-Label Trial 
Objective: To continue evaluation of the use of acyclovir suppression in late pregnancy after first episode genital herpes simplex virus (HSV) infection, using an open-label study design.
Methods: Ninety-six women diagnosed with genital herpes for the first time in the index pregnancy were prescribed suppressive acyclovir 400 mg orally three times daily from 36 weeks until delivery in an open-label fashion. Herpes cultures were obtained when patients presented for delivery. Vaginal delivery was permitted if no clinical recurrence was present; otherwise a Cesarean delivery was performed. NeonatalHSV cultures were obtained and infants were followed clinically. Rates of clinical and asymptomatic genital herpes recurrences and Cesarean delivery for genital herpes were measured, and 95% confidence intervals were calculated.
Results: In 82 patients (85%) compliant with therapy, only 1% had clinical HSV recurrences at delivery. In an intent to treat analysis of the entire cohort, 4% had clinical recurrences (compared with 18–37% in historical controls). Asymptomatic shedding occurred in 1% of women without lesions at delivery. Two of the four clinical recurrences were HSV-culture positive. No significant maternal or fetal side-effects were observed.
Conclusions: In clinical practice the majority of patients are compliant with acyclovir suppression at term. The therapy appears to be effective at reducing clinical recurrences after a first episode of genital herpes complicating a pregnancy.
PMCID: PMC1784644  PMID: 11495557
3.  Malaria in Pregnancy 
This review summarizes the epidemiology, clinical course, and diagnosis of malaria. The influence of infection during pregnancy upon maternal and neonatal anemia, stillbirth, preterm labor, low birth weight, and congenital malaria is discussed. Options for treatment and prophylaxis during pregnancy are presented.
PMCID: PMC2364524  PMID: 18476133
4.  Fluconazole (Diflucan®) 
PMCID: PMC2364443  PMID: 18476045

Results 1-4 (4)