Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Chorioamnionitis

Most likely pathogens

Duration of Therapy

Continue intrapartum antibiotics for at least one additional postpartum dose or until afebrile and asymptomatic for 24 hours

Note

There is no evidence that oral antibiotics are beneficial following IV therapy

Suggested Regimen

Ampicillin 1-2g IV q6h

AND

Gentamicin

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

AND

If cesarean delivery, for anaerobic coverage:

Metronidazole 500 mg IV/ q12h

OR

Cefazolin 1-2 grams IV q8h

AND

Metronidazole 500 mg IV/PO q12h

Penicillin Allergy

Cefazolin 1-2 grams IV q8h

AND

Metronidazole 500 mg IV/PO q12h

OR

Clindamycin 600-900 mg IV q8h

AND

Gentamicin

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