Chorioamnionitis medical therapy
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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.