Antibiotic Regimens for Treatment of Intraamniotic Infection

Recommended Antibiotics

1. Ampicillin 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 hours

Recommended Antibiotics (Mild Penicillin Allergy)

1. Cefazolin 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 hours

Recommended Antibiotics (Severe Penicillin Allergy)

1. Clindamycin 900 mg IV every 8 hours

2. or

3. Vancomycin* 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 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.

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

Alternative Regimens

1. Ampicillin-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 hours

4. Cefoxitin 2 g IV every 8 hours

5. Ertapenem 1 g IV every 24 hours

Postcesarean delivery: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.