Obstetrics Book

Fetal Disorders

Perinatal Disorders

Prevention

http://www.fpnotebook.com/

Endometritis Antibiotic ManagementAka: Chorioamnionitis Antibiotic Management

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  1. Management: Antibiotics
    1. Common Protocol
      1. Ampicillin 2 g IV every 6 hours
      2. Gentamycin 1.5 mg/kg (Maximum 80-100 mg) q8 hours
        1. Adjust dosing per kinetics if >1-2 days use
    2. Alternative Medications
      1. Mezlocillin 3 grams IV every 4 hours
      2. Piperacillin 3 grams IV every 4 hours
      3. Timentin 3.1 grams IV every 6 hours
      4. Unasyn 3 grams IV every 4-6 hours
  2. Management: Antibiotics added anaerobic coverage
    1. Indications
      1. Cesarean section
      2. Foul amniotic discharge
    2. Agents
      1. Clindamycin 900 mg IV every 6 hours
      2. Flagyl 15 mg/kg IV load then 7.5 mg/kg IV q6 hours
  3. Management: Antibiotics added Chlamydia coverage
    1. Indications
      1. Late onset Endometritis (>48 hours postpartum)
      2. Chlamydia culture positive
    2. Agents
      1. Zithromax 1 gram PO x1 dose
      2. Erythromycin 500 mg PO qid for 7 days
      3. Erythromycin Ethylsuccinate (EES)
        1. Dose: 800 mg PO qid for 7 days
      4. Doxycycline 100 mg PO bid
        1. Do not use intrapartum or in Lactation

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