How is postpartum septic pelvic phlebitis treated?

Updated: Oct 11, 2019
  • Author: Andy W Wong, MD; Chief Editor: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE  more...
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Answer

Broad-spectrum antibiotics should be administered. Initial choice of antibiotics should cover gram-positive, gram-negative, and anaerobic organisms. Ampicillin and gentamicin with metronidazole or clindamycin is a common regimen. [12, 13]

Anticoagulation may be used, and it should be noted that there exists no universal guideline or recommendation for anticoagulation therapy in septic pelvic thrombosis. Initial bolus of 60 units/kg (4000 units maximum) followed by 12 units/kg/h (maximum of 1000 units/h) is recommended. [5] The aPTT is monitored for 2-3 times the normal value. [12, 13]

Alternatively, low-molecular weight heparin may be used with a dose of 1 mg/kg. [12, 13]


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