Antibiotic prophylaxis

a. Antibiotic therapy is important in the management of patients with PPROM.

b. Ampicillin (1 or 2 g IV every 6 hours for 24 hours, then 500 mg PO every 6 hours until delivery) plus erythromycin or azithromycin is recommended.

(1) Azithromycin (Zithromax, 1 g orally as a single dose) may be substituted for erythromycin because of improved oral absorption, a broader spectrum of antibacterial properties, and better tolerance.

(2) Women with bacterial vaginosis should be treated with metronidazole (250 mg PO three times daily for seven days).

Sample Antibiotic Regimens Used for Prophylaxis in Women with PPROM

Antibiotic

Dose

Ampicillin

1 or 2 g IV every 6 hours for 24 hours, then 500 mg PO every 6 hours until delivery

Ampicillin Gentamicin

Clindamycin

Amoxicillin plus clavulanic acid (Augmentin)

2 g IV every 6 hours for 4 doses and

90 mg IV initially, then 60 mg IV every 8 hours for three doses and 900 mg IV every 8 hours for three doses, followed by 500 mg PO TID for 7 days

Erythromycin base

333 mg PO every 8 hours until delivery

Piperacillin

3 g IV every 6 hours for 3 days

Ampicillin-sulbactam (Unasyn)

3 g every 6 hours for 7 days

Ampicillin

2 g IV every 6 hours for 7 days

Ampicillin-sulbactam Amoxicillin-clavulante

1.5 g IV every 6 hours for 72

hours, followed by

500 mg PO every 8 hours until delivery

References: See page 184.

References: See page 184.

Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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