6.8 Puerperal sepsis
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Puerperal sepsis: defined as: “‘a serious infection of the genital tract which occurs within 42 days of delivery | Inj Piperacillin- tazobactam 4.5g IV q6h for 7-14 days | Clindamycin 600-900mg IV q8h + Gentamicin 5mg/kg IV OD (if penicillin allergic) for 7- 14 days | |
| Puerperal sepsis in Septic Shock | Imipenem-cilastatin 500mg IV q6h / Meropenem 1g IV q8h for 7 -14 days | Consider optimum and appropriate antibiotics like Vancomycin 1g BD, or Teicoplanin 400mg q12h for 3 doses followed by 400mg OD to cover MRSA with a total duration of therapy for 14 days. |
For common etiological agents of Puerperal sepsis, see Annexure B.6.8
Additional Information
- Presence of 2 or more of the following symptoms - Pelvic pain, Pyrexia i.e.oral temperature 38.5°C or higher on any occasion, Abnormal vaginal discharge, e.g. presence of pus or discharge with a foul odour, Delay in the rate of reduction of the size of the uterus (<2cm/day during the first 8 days) indicate puerperal sepsis.
- It is important to consider and cover C.sordelliand C.perfringensin emergency sepsis cases