II. 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

III. 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

IV. 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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