| Diagnosis | Common Pathogens | Drug(s) of First Choice | Alternative Drug(s) | Comments | Expected Duration |
|---|---|---|---|---|---|
| Chorioamnionitis | Bacteroides Prevotella bivia Group B & A streptococci Enterobacterales M. hominis | Ceftriaxone PLUS Metronidazole | For severe cephalosporin allergy: For severe beta-lactam allergy: | Recommendations are consistent regardless of delivery method (vaginal vs. Cesarean). | After delivery, continue antibiotics for one dose each unless the patient is diagnosed with endometritis. If so, refer to Endometritis section. Antibiotics should be continued at recommended dosing interval, even if periprocedural cephalosporins are administered (i.e. no need to postpone first ceftriaxone dose if cefazolin is given periprocedurally).
|
| Endometritis | Bacteroides Prevotella bivia Group B & A streptococci Enterobacterales M. hominis | Ceftriaxone PLUS Metronidazole | For severe cephalosporin allergy: For severe beta-lactam allergy: | If positive chlamydia testing, add azithromycin or doxycycline. | Continue antibiotics until patient is afebrile for 24-48 hours. If still febrile > 48 hours on antibiotic regimen postpartum, follow healthcare-associated secondary peritonitis recommendations for which antibiotics to escalate to. Wait 48 hours on an antibiotic regimen before considering regimen failed. |
Patient Population:
Adult