Chorioamnionitis medical therapy: Difference between revisions

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*Cesarean section is reserved only for obstetrics indications, and antimicrobial coverage for anaerobes is required for such cases.
 
*
*Antimicrobial therapy should be started once the diagnosis is confirmed to improve maternal and fetal outcomes.
*Cesarean section is preserved only for obstetrics indications, and antimicrobial coverage for anaerobes is required for such cases.
*A single daily dose of [[gentamicin]] is preferred than multiple doses a day. It has better efficacy and less toxicity.
*Short term regimen(24 hours after fever resolution)has the same efficacy as prolonged regimen.
*Current recommendations are against [[corticosteroids]] use for women with intraamniotic infection.
*No proven benefit has been shown of using antimicrobial prophylaxis.


==Antipyretic Therapy==
==Antipyretic Therapy==

Revision as of 07:55, 19 February 2014

Chorioamnionitis Microchapters

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Antimicrobial Therapy

Chorioamnionitis/Septic Abortion Treatment
Preferred Regimen
Cefoxitin 2 gm IV q6–8h
OR
Ticarcillin-Clavulanate 3.1 gm IV q4–6h
OR
DoripenemNAI 500 mg IV q8h
OR
Imipenem 0.5 gm IV q6h
OR
Meropenem 1 gm IV q8h
OR
Ampicillin-Sulbactam 3 gm IV q6h
OR
Ertapenem 1 gm IV q24h'
OR
Pipracillin-Tazobactam 4.5 gm IV q6h (or 4-hr infusion of 3.375 gm q8h)
PLUS
Doxycycline 100 mg IV/po q12h
OR
Clindamycin 450–900 mg IV q8h
PLUS
Ceftriaxone 2 gm IV q24h
OR
Gentamicin MDD: 2 mg per kg load, then 1.7 mg per kg q8h or OD: 5.1 (7 if critically ill) mg per kg q24h
  • Antimicrobial therapy should be started once the diagnosis is confirmed to improve maternal and fetal outcomes.
  • Cesarean section is preserved only for obstetrics indications, and antimicrobial coverage for anaerobes is required for such cases.
  • A single daily dose of gentamicin is preferred than multiple doses a day. It has better efficacy and less toxicity.
  • Short term regimen(24 hours after fever resolution)has the same efficacy as prolonged regimen.
  • Current recommendations are against corticosteroids use for women with intraamniotic infection.
  • No proven benefit has been shown of using antimicrobial prophylaxis.

Antipyretic Therapy

Acetaminophen use for febrile patients with chorioamnionitis has shown remarkable improvement in fetal vitals and acid-base balance, with no increased risk for complications.


References

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