This guideline lists the more common antibiotics given for each condition.  Appropriate microbiology samples should always be taken prior to commencement of antibiotics; the prescription may be altered on receipt of laboratory test results if antibiotic initially prescribed is not listed as ‘sensitive’.

Please refer to antibiotics in BLUE for patients with penicillin allergy.

Condition Specific Antibiotic Prescription Method of Administration
Bacterial Vaginosis Metronidazole

or

Clindamycin

 400mg bd

 

300mg bd

 Oral for 7 days
Caesarean section

Augmentin  

or

1.2g Intravenous. Single dose as prophylaxis
Cefuroxime &

Metronidazole

750mg

500mg/100mls (bag)

 Intravenous. Single dose as prophylaxis
Chlamydia Erythromycin 500mg qds

Oral for 7 days

*refer partner with patient to GUM Clinic
Chorioamnionitis

Cefuroxime &

 Metronidazole

750mg

500mg/100mls (bag)

 Give both antibiotics intravenously every 8 hours until delivery

Group B Streptococci

 Benzylpenicillin

or

 One dose of PenG 3g, then a further dose of 1.5g Intravenous from onset of labour, every 4 hours until delivery
Clindamycin

900mg

 

 Intravenous from onset of labour, every 12 hours until delivery
Valvular heart disease (heart murmur)

Amoxycillin &

Gentamicin  

or

1g

120mg

Give both antibiotics intravenously from onset of labour, every 8 hours until delivery

Vancomycin &

Gentamicin

1g

120mg		 Give both antibiotics intravenously from onset of labour, every 12 hours until delivery

Herpes Genitalis

Zovirax cream 5%

and oral Zovirax

 

200mg x 5 od

 

Oral for 5 days

Recurrent herpes Zovirax 200mg 1-4 times daily Oral until delivery
Preterm/prolonged rupture of membranes

Erythromycin

(avoid Augmentin)

 500mg qds Oral  for 10 days or until delivery

Retained placenta (MROP)

 Cefuroxime &

Metronidazole

750mg

500mg/100mls (bag)

 Intravenous single dose as prophylaxis
Retained products of conception (RPOC)

Co-Amoxiclav 250/125 (Augmentin)

 500mg tds

Oral for 7 days . If clinically unwell may require antibiotics intravenously initially
Third & fourth degree tear Cefuroxime &

Metronidazole

750mg

500mg/100mls bag		 Intravenous single dose as prophylaxis, plus 7 days oral
Urinary tract infection

Cephalexin (Cefalexin)

Nitrofurantoin (avoid in 3rd trimester)

250mg qds or 500mg tds/qds

100mg qds

Oral for 7 days

 Oral for 7 days
Uterine inversion Cefuroxime &

Metronidazole

750mg

500mg/100mls (bag)

 Intravenous single dose plus 7 days oral
Wound infection

Flucloxicillin

(consider also using Metronidazole)

500mg qds

(500mg qds)

 Oral for approximately 7 days

    

NB
  1. Please check patients allergy status before drug prescription and administration.
  2. Please refer to intravenous antibiotic guideline for reconstitution and dilution of each individual antibiotic.
  3. Patients with restricted intake will require a revised dilution and infusion rate for intravenous antibiotics - consult with registrar.
  4. Please refer to the BNF and/or contact Drug Information on extension 2297 for advice if necessary.
  5. Please forward any microbiology sample results for outpatients to the listed General Practitioner ,also advise GP and woman verbally if the given antibiotic given requires changing to an antibiotic that is listed as 'sensitive' re: microbiology report.

 

 Author

M Dobson , D Pillay

Guideline No: 85 – Antibiotics in pregnancy and during labour

Version: 1.1.1

Dated: January 2007