34. Obstetrics and Gynaecology

Procedure

Antibiotic

Dose

Route

Dosing Interval

Comment

Caesarean section

Co-amoxiclav

1.2g

IV

Single dose
after umbilical cord clamped

Use cefuroxime 750mg if penicillin allergic (rash)

Hysterectomy (abdominal & vaginal)

Co-amoxiclav

1.2g

IV

Single dose at start of procedure

Use cefuroxime 750mg if penicillin allergic (rash)

Induced abortion

Metronidazole
+/-
azithromycin
(see comments)

PR

PO

At the time of abortion
On the day of abortion

Give both metronidazole and azithromycin if no swab results available or if positive for chlamydia. Only metronidazole if chlamydia swab negative. Use doxycycline 100mg BD for 7 days starting on the day of abortion if azithromycin allergic.

Procedure	Antibiotic	Dose	Route	Dosing Interval	Comment
Caesarean section	Co-amoxiclav	1.2g	IV	Single dose after umbilical cord clamped	Use cefuroxime 750mg if penicillin allergic (rash)
Hysterectomy (abdominal & vaginal)	Co-amoxiclav	1.2g	IV	Single dose at start of procedure	Use cefuroxime 750mg if penicillin allergic (rash)
Induced abortion	Metronidazole +/- azithromycin (see comments)	PR PO		At the time of abortion On the day of abortion	Give both metronidazole and azithromycin if no swab results available or if positive for chlamydia. Only metronidazole if chlamydia swab negative. Use doxycycline 100mg BD for 7 days starting on the day of abortion if azithromycin allergic.