Septic Pelvic Thrombophlebitis

Duration of Therapy

Total duration depends upon clinical improvement (usually 7 days)

Discontinue antibiotics following clinical improvement (including afebrile for at least 48 hours) and resolution of leukocytosis

In the absence of septic emboli or other complicated infection or positive blood cultures, antibiotics do not need to be continued upon discharge

Positive blood cultures should prompt an extension of the course (14 days) and further evaluation

Suggested Regimen

Cefazolin 1-2 grams IV q8h

AND

Metronidazole 500 mg IV/PO q12h

AND

If positive for Chlamydia:

Doxycycline 100 mg PO q12h

OR

Ceftriaxone 1 g IV q24h

AND

Metronidazole 500 mg IV/PO q12h

AND

If positive for Chlamydia:

Doxycycline 100 mg PO q12h

Penicillin Allergy

Clindamycin 600-900 mg 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