COMMON ANTIBIOTICS USED IN OBSTETRICS

INFECTION/ OUR PRACTICE PREFERED ALTERNATIVE REMARKS

CONDITION
PPROM T Erythromycin Ethylsuccinate T Erythromycin Ethylsuccinate
(NON-GBS CARRIER) 400mg BD 10 days 400mg QID 7-10 days

PPROM IV Ampicillin 2gm QID 48H

(GBS CARRIER) then T Amoxicillin 500mg TDS 5-7
<34 OF GESTATIONS days (NAG)

+ T. Azithromycin 1gm upon

admission (STAT dose)

GBS POSITIVE IV Penicillin G 5mu STAT then IV Penicillin G 5mu STAT then IV Cefazolin 2gm STAT then
(INTRAPARTUM 2.5mu 4 hourly 2.5mu 4 hourly until delivery 1gm 4 hourly until delivery
PROPHYLAXIS)
OR OR

IV Ampicillin 2gm STAT then 1g 4 IV Clindamycin 900mg 8 hourly

hourly until delivery until delivery

OR
IV Erythromycin 500mg 6
hourly until delivery

CHORIOAMNIONITIS IV Cefuroxime 750mg TDS
+ IV Metronidazole 500mg
TDS
IV Ampicillin 2gm QID
+ IV Gentamicin 5mg/kg OD
+ IV Metronidazole 500mg QID (if
patient undergoing C-sec)
IV Unasyn 3gm QID *Antibiotic is continued
postpartum until patient is
Penicillin allergy: afebrile or asymptomatic at least
IV Clindamycin 900mg TDS 48 hours
SEPTIC IV Cefuroxime 750mg TDS IV Ampicillin 2gm QID IV Unasyn 3g QID
MISCARRIAGE + IV Metronidazole 500mg + T Doxycycline 100mg BD
TDS + IV Gentamicin 5mg/kg OD
OR
+ IV Metronidazole 500mg TDS
IV Clindamycin 900mg TDS
+ T Gentamicin 5mg/kg OD

UTI IN PREGNANCY T Cephalexin 500mg BD T Nitrofurantoin 50-100mg QID T Cefuroxime 250mg BD 5 days *avoid in 3rd trimester

OR OR

T Cephalexin 500mg BD T Augmentin 625mg 5 days

(To use in 3rd trimester)
OR
UTI (Non pregnant) T Nitrofurantoin 50-100mg QID 5
days T Unasyn 375mg BD 5 days

OR

T Cephalexin 500mg BD 5 days

PYELONEPHRITIS IV Cefuroxime 750mg TDS OUTPATIENT: IV Rocephine 1gm OD

+ IV Metronidazole 500mg T Augmentin 125mg TDS 14 days
TDS
OR
T Unasyn 375mg BD 14 days

INPATIENT:
IV Augmentin 1.2gm TDS
OR
IV Cefuroxime 750mg TDS
OR
IV Unasyn 1.5-3.0gm TDS
 COMMON ANTIBIOTICS USED IN GYNAECOLOGY

INFECTION/ OUR PRACTICE PREFERED ALTERNATIVE REMARKS

CONDITION
PELVIC IV Cefuroxime 750mg TDS OUTPATIENT (Mild - Moderate):
INFLAMMATORY 14 days IM Ceftriaxone 1000mg STAT
DISEASE (*BASHH guideline)
+ IV Metronidazole 500mg OR
TDS 14 days IM Cefotaxime 1gm STAT

+ T Metronidazole 400mg BD 14
days

+ T Doxycycline 100mg BD 14
days
OR
+ T Azithromycin 1gm once per
week for 2 weeks

INPATIENT (Moderate – severe):
IV Cefuroxime 1.5gm TDS 14
days
OR
IV Ceftriaxone 2gm OD
IV Unasyn 3gm QID 14 days IV antibiotics until 24H after
clinical improvement, then
+ T Doxycycline 100mg BD 14 days changed to oral

+ T Doxycycline 100mg BD 14
days
+ IV/T Metronidazole 500mg TDS
14 days
ENDOMETRITIS IV Cefuroxime 750mg TDS NON PREGNANCY:
14 days Follow regime for severe PID

+ IV Metronidazole 500mg
TDS 14 days
POSTPARTUM: IV Augmentin 1.2gm TDS 10- 14
IV Clindamycin 900mg TDS 10- days
14 days OR
+ IV Gentamicin 5mg/kg OD 10- IV Unasyn 3gm QID 10- 14 days
14 days
OR
IV Cefotaxime 1gm TDS 10- 14
days
+ IV Metronidazole 500mg TDS
10- 14 days
+ IV Gentamicin 5mg/kg STAT

*Requires TDM monitoring

VAGINITIS T Metronidazole 500mg BD T Metronidazole 400mg TDS 7 T Clindamycin 300mg BD 7 days
days

TRICHOMONIASIS T Metronidazole 500mg BD T Metronidazole 400mg TDS 7

days
OR
T Metronidazole 2gm STAT

CERVICITIS No antibiotic given T Azithromycin 1gm STAT T Doxycycline 100mg BD 7 days

VAGINAL Clotrimazole Pessary 500mg ACUTE:

CANDIDIASIS OD STAT T Fluconazole 150mg OD STAT
(NON PREGNANT) OR
Clotrimazole Pessary 500mg OD
STAT
 RECURRENT: 4 episodes/year with at least 2
T Fluconazole 150mg OD every 72 positive cultures or microscopy
hours for 3 doses, then 150mg once
per week for 6 months
OR
Clotrimazole pessary 500mg 7-14
days according to response, then
500mg once per week for 6 months

VAGINAL Clotrimazole Pessary 500mg ACUTE:

CANDIDIASIS OD STAT Clotrimazole Pessary 500mg OD
(PREGNANT) for 7 days

RECURRENT:
Clotrimazole pessary 500mg 7-14
days according to response, then
500mg once per week for 6 months

POSTPARTUM IV Cloxacillin 1gm QID OUTPATIENT: IV Cefazolin 1.2gm TDS Durations : 5-7 days
MASTITIS T Cephalexin 50mg QID

INPATIENT:
IV Cloxacillin 2gm QID

EPISIOTOMY IV Cloxacillin 1gm QID First or second degree: *Penicillin allergy

WOUND No antibiotic required IV Clindamycin 600mg STAT
BREAKDOWN
Third or fourth degree:
IV Cefuroxime 1.5gm STAT
 COMMON ANTIBIOTICS USED IN OBSTETRICS AND GYNAECOLOGY PROCEDURES

PROCEDURE OUR PRACTICE PREFERED ALTERNATE REMARKS

MANUAL REMOVAL IV Cefuroxime 1.5gm STAT IV Ampicillin 2gm STAT IV Cefazolin 2gm STAT
OF PLACENTA/ EUA
+ IV Metronidazole 500mg
STAT
CESAREAN SECTION IV Cefuroxime 1.5gm STAT IV Cefazolin 2gm STAT IV Unasyn 3gm STAT
(3gm for patients >120kg)

OR

IV Cefuroxime 1.5g STAT

+ IV Metronidazole 500mg STAT

(*TOG 2021)

POST CESAREAN IV Cloxacillin 2gm QID IV Unasyn 3gm TDS

SECTION INFECTION
(SSI) OR

IV Cefazolin 1-2gm TDS

ELECTIVE SURGERY IV Cefuroxime 1.5gm STAT IV Cefazolin 2gm STAT IV Unasyn 3gm STAT
Eg: TABHSO, (3gm for patients >120kg)
HYSTERECTOMY,
LAPAROSCOPY, OR
VAGINA
IV Cefuroxime 1.5gm STAT

+ IV Metronidazole 500mg STAT

(*TOG 2021)
LAPAROSCOPIC Antibiotic not given Antibiotic not recommended
SURGERY
REPAIR OF IV Cefuroxime 1.5gm STAT IV Cefazolin 2gm STAT IV Unasyn 3gm STAT Durations : 5 – 7 days
PERINEAL TEAR IV Metronidazole 500mg (3gm for patients >120kg)
Eg: Third and fourth STAT
degree tears + IV Metronidazole 500mg STAT

EMERGENCY As per elective surgery

LAPAROTOMY
SURGICAL T Doxyclycline 400mg STAT
TERMINATION OF (1 hour prior operation)
PREGNANCY
OR

T Azithromycin 1gm STAT (1 hour

prior operation)