6.3 Septic abortion
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Septic Abortion – Fever, Vaginal discharge, pelvic/abdominal pain, etc | Ampicillin 2g IV q6h + Gentamicin 5 mg/kg daily IV + Metronidazole 500 mg IV q8h Or Amoxicillin-clavulanic acid 1.2g q8h IV for 7-10 days | Clindamycin 600 IV q8h + Gentamicin 5 mg/kg daily IV for 7-10 days | Be vigilant and suspect sepsis early. These symptoms usually appear within 24 to 48 hours after an abortion. Obtain blood and cervical cultures to help guide antibiotic therapy. |
| Complicated with Sepsis-Associated with organdysfunction (Peritonitis,Vaginal bleeding, andSevere pelvic/abdominalpain). | Piperacillin-tazobactam 4.5g IV q6h, for 7-10 days |
Meropenem 1g IV q8h for 7-10 days |
For common etiological agents of Septic abortion, see Annexure B.6.3
Additional Information
- Evacuation of any retained product of conception is crucial for optimal response.
References
1. Abortion care guideline. Geneva: World Health Organization; 2022. Licence: CC BY-NC- SA 3.0 IGO. Available from: https://iris.who.int/bitstream/handle/10665/349316/9789240039483-eng.pdf?sequence=1
2. Udoh A, Effa EE, Oduwole O, Okusanya BO, Okafo O. Antibiotics for treating septic abortion. Cochrane Database Syst Rev. 2016 Jul 1;7(7):CD011528. doi: 10.1002/14651858.CD011528.pub2. PMID: 27364644; PMCID: PMC6458041.