Guideline for Infection and Obstetric patients: Pyrexia in pregnancy and labour.

Pyrexia in labour:

A temperature >38 ^oC is a serious complication of labour.

• If the temperature remains > 38^oC for 30 minutes, start antibiotics:
  • IV Amoxicillin 2g plus IV Metronidazole 500mg stat then IV Amoxicilln 1g tds plus Metronidazole 500mg tds until delivery.
  • If pencillin allergy give IV Clindamycin 900mg qds until delivery.
  • Add Gentamicin immediately if the patient has severe sepsis (hypotension which fails to respond to an initial fluid bolus) or if there is no improvement after 24 hours and seek advice from a medical microbiologist

Notes:

• The continuation of antibiotics after the delivery depends on clinical status.
• A maximum of 5 days oral antibiotics is generally sufficient if additional antibiotics are needed after delivery. Click here for oral alternatives.

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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