Antibiotic Regimens for Treatment of Intraamniotic Infection

Recommended Antibiotics

1. Ampicillin 2 g IV every 6 hoursAmpicillin 2 g IV every 6 hours

2. and

3. Gentamicin 2 mg/kg IV (loading dose) followed by 1.5 mg/kg IV every 8 hours OR 5 mg/kg IV every 24 hoursGentamicin 2 mg/kg IV (loading dose) followed by 1.5 mg/kg IV every 8 hours OR 5 mg/kg IV every 24 hours

Recommended Antibiotics (Mild Penicillin Allergy)

1. Cefazolin 2 g IV every 8 hoursCefazolin 2 g IV every 8 hours

2. and

3. Gentamicin 2 mg/kg IV (loading dose) followed by 1.5 mg/kg IV every 8 hours OR 5 mg/kg IV every 24 hoursGentamicin 2 mg/kg IV (loading dose) followed by 1.5 mg/kg IV every 8 hours OR 5 mg/kg IV every 24 hours

Recommended Antibiotics (Severe Penicillin Allergy)

1. Clindamycin 900 mg IV every 8 hoursClindamycin 900 mg IV every 8 hours

2. or

3. Vancomycin* 1 g IV every 12 hoursVancomycin* 1 g IV every 12 hours

4. and

5. Gentamicin 2 mg/kg IV (loading dose) followed by 1.5 mg/kg IV every 8 hours OR 5 mg/kg IV every 24 hoursGentamicin 2 mg/kg IV (loading dose) followed by 1.5 mg/kg IV every 8 hours OR 5 mg/kg IV every 24 hours

Postcesarean delivery: One additional dose of the chosen regimen is indicated. Add clindamycin 900 mg IV or metronidazole 500 mg IV for at least one additional dose.One additional dose of the chosen regimen is indicated. Add clindamycin 900 mg IV or metronidazole 500 mg IV for at least one additional dose.

Postvaginal delivery: No additional doses required; but if given, clindamycin is not indicated. No additional doses required; but if given, clindamycin is not indicated.

Alternative Regimens

1. Ampicillin-sulbactam 3 g IV every 6 hoursAmpicillin-sulbactam 3 g IV every 6 hours

2. Piperacillin-tazobactam 3.375 g IV every 6 hours or 4.5 g IV every 8 hours

3. Cefotetan 2 g IV every 12 hoursCefotetan 2 g IV every 12 hours

4. Cefoxitin 2 g IV every 8 hoursCefoxitin 2 g IV every 8 hours

5. Ertapenem 1 g IV every 24 hoursErtapenem 1 g IV every 24 hours

Postcesarean delivery: One additional dose of the chosen regimen is indicated. Additional clindamycin is not required.One additional dose of the chosen regimen is indicated. Additional clindamycin is not required.

Postvaginal delivery: No additional doses required; but if given, clindamycin is not indicated. No additional doses required; but if given, clindamycin is not indicated.