Chorioamnionitis medical therapy: Difference between revisions
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{{Chorioamnionitis}} | {{Chorioamnionitis}} | ||
=Overview= | =Overview= | ||
Antimicrobial therapy is indicated | Antimicrobial therapy is indicated among patients with chorioamnionitis. The preferred regimen is a combination of [[ampicillin]] and [[gentamicin]]. Supportive therapy, such as antipyretics, may also be used. | ||
==Medical Therapy== | ==Medical Therapy== | ||
*1. ''' | Medical therapy for chorioamnionitis includes antimicrobial therapy and antipyretic therapy: | ||
:* Preferred regimen: [[Ampicillin]] 2 g IV q6h {{or}} [[ | *1. '''Chorioamnionitis'''<ref name="pmid17400872">{{cite journal| author=ACOG Committee on Practice Bulletins-Obstetrics| title=ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. | journal=Obstet Gynecol | year= 2007 | volume= 109 | issue= 4 | pages= 1007-19 | pmid=17400872 | doi=10.1097/01.AOG.0000263888.69178.1f | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17400872 }} </ref><ref name="pmid20569811">{{cite journal| author=Tita AT, Andrews WW| title=Diagnosis and management of clinical chorioamnionitis. | journal=Clin Perinatol | year= 2010 | volume= 37 | issue= 2 | pages= 339-54 | pmid=20569811 | doi=10.1016/j.clp.2010.02.003 | pmc=PMC3008318 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20569811 }} </ref> | ||
:* | :* Preferred regimen: [[Ampicillin]] 2 g IV q6h {{and}} ([[Gentamicin]] 1.5 mg/kg IV q8h {{or}} [[Gentamicin]] 5 mg/kg IV q24h) until delivery {{then}} ([[Ampicillin]] 2 g IV in a single dose {{or}} [[Gentamicin]] 5 mg/kg IV in a single dose) postpartum. | ||
:*Alternative regimen, penicillin-allergic: [[Clindamycin]] 900 mg IV q8h {{and}} ([[Gentamicin]] 1.5 mg/kg IV q8h {{or}} [[Gentamicin]] 5 mg/kg IV q24h) until delivery {{then}} ([[Clindamycin]] 900 mg IV in a single dose {{or}} [[Gentamicin]] 5 mg/kg IV in a single dose) postpartum. | |||
:* Note ( | :* Note (1): For patients with cesarean section who are not penicillin-allergic, add [[Metronidazole]] 500 mg IV in a single dose only after clamping the umbilical cord. | ||
:* Note ( | :* Note (2): For patients with cesarean section who are penicillin-allergic, [[Metronidazole]] should not be added post-partum. | ||
:* Note ( | :* Note (3): Chorioamnionitis is a contraindication to the administration of [[Corticosteroids]]. Women with intra-amniotic infection have traditionally been excluded from randomized trials of corticosteroid therapy. | ||
*2. '''Supportive measures''' | *2. '''Supportive measures'''<ref name="pmid17400872">{{cite journal| author=ACOG Committee on Practice Bulletins-Obstetrics| title=ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. | journal=Obstet Gynecol | year= 2007 | volume= 109 | issue= 4 | pages= 1007-19 | pmid=17400872 | doi=10.1097/01.AOG.0000263888.69178.1f | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17400872 }} </ref> | ||
:* Preferred regimen: Antipyretics ([[Acetaminophen]]) | :* Preferred regimen: Antipyretics ([[Acetaminophen]]) | ||
==References== | ==References== | ||
Revision as of 18:46, 24 September 2015
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Overview
Antimicrobial therapy is indicated among patients with chorioamnionitis. The preferred regimen is a combination of ampicillin and gentamicin. Supportive therapy, such as antipyretics, may also be used.
Medical Therapy
Medical therapy for chorioamnionitis includes antimicrobial therapy and antipyretic therapy:
- Preferred regimen: Ampicillin 2 g IV q6h AND (Gentamicin 1.5 mg/kg IV q8h OR Gentamicin 5 mg/kg IV q24h) until delivery THEN (Ampicillin 2 g IV in a single dose OR Gentamicin 5 mg/kg IV in a single dose) postpartum.
- Alternative regimen, penicillin-allergic: Clindamycin 900 mg IV q8h AND (Gentamicin 1.5 mg/kg IV q8h OR Gentamicin 5 mg/kg IV q24h) until delivery THEN (Clindamycin 900 mg IV in a single dose OR Gentamicin 5 mg/kg IV in a single dose) postpartum.
- Note (1): For patients with cesarean section who are not penicillin-allergic, add Metronidazole 500 mg IV in a single dose only after clamping the umbilical cord.
- Note (2): For patients with cesarean section who are penicillin-allergic, Metronidazole should not be added post-partum.
- Note (3): Chorioamnionitis is a contraindication to the administration of Corticosteroids. Women with intra-amniotic infection have traditionally been excluded from randomized trials of corticosteroid therapy.
- 2. Supportive measures[1]
- Preferred regimen: Antipyretics (Acetaminophen)
References
- ↑ 1.0 1.1 ACOG Committee on Practice Bulletins-Obstetrics (2007). "ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists". Obstet Gynecol. 109 (4): 1007–19. doi:10.1097/01.AOG.0000263888.69178.1f. PMID 17400872.
- ↑ Tita AT, Andrews WW (2010). "Diagnosis and management of clinical chorioamnionitis". Clin Perinatol. 37 (2): 339–54. doi:10.1016/j.clp.2010.02.003. PMC 3008318. PMID 20569811.