What are the SPILF/CNGOF guidelines on the treatment of postpartum endometritis?

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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Preferred: The first-line antibiotic is amoxicillin-clavulanic acid 3-6 g/d (depending on weight) IV or PO.

Penicillin allergy: In patients with penicillin allergy, a combination of clindamycin 600 mg 4 times/day plus gentamicin 5 mg/kg once a day may be used (caution in breastfeeding women).

Duration: Treatment is administered until 48 hours of apyrexia and resolved pelvic pain. If fever or pelvic pains pain persists for more than 72 hours of antibiotic therapy, perform pelvic imaging to evaluate for placental retention, septic thrombophlebitis, deep abscess, or other surgical complications.

Septic thrombophlebitis, if present, should be treated with heparin therapy for 6 weeks or more if embolism or thrombotic risk factors are also present.

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