Inpatient Management Endometritis

Duration of Therapy

Clinical improvement (no fundal tenderness) and afebrile X 24 hours. Oral therapy usually not indicated

If patient bacteremic, complete 7-14 day total course with oral antibiotics such as amoxicillin/clavulanic acid or based upon culture and sensitivity

Suggested Regimen

Cefazolin 1-2 grams IV q8h

AND

Metronidazole 500 mg IV/PO q12h

AND

If positive for Chlamydia, add:

Doxycycline 100 mg PO q12h

OR

Ceftriaxone 1 g IV q24h

AND

Metronidazole 500 mg IV/PO q12h

AND

If positive for Chlamydia, add:

Doxycycline 100 mg PO q12h

Penicillin Allergy

Clindamycin 600-900 mg/dose IV q8h

AND

Gentamicin

5 mg/kg/dose IV q24h
Maximum: 500 mg/24 h prior to levels

OR

Ceftriaxone 1 g IV q24h

AND

Metronidazole 500 mg IV/PO q12h