Chorioamnionitis

Diagnosis Common Pathogens Drug(s) of First Choice Alternative Drug(s) Comments Expected Duration

Chorioamnionitis

Post-partum

(vaginal delivery)

Bacteroides

Prevotella bivia

Group B & A streptococci

Enterobacteriaceae

M. hominis

1st line: Cefoxitin

2nd line: Ertapenem

For severe PCN allergy:

If GBS neg or Clindamycin-sensitive GBS:

Clindamycin

PLUS

Gentamicin

IF GBS pos and Clinda resistant/resistance unknown:

Vancomycin

PLUS

Gentamicin

  Antibiotics are continued for one dose after delivery unless the patient is diagnosed with endometritis

Chorioamnionitis

Post-partum

(Cesarean delivery)

Bacteroides

Prevotella bivia

Group B & A streptococci

Enterobacteriacae

M. hominis

1st line: Cefoxitin

2nd line: Ertapenem

For severe PCN allergy:

Regardless of GBS status:

Vancomycin

PLUS

Gentamicin

PLUS

Metronidazole
  Continue antibiotics until afebrile for 24 hours