Guideline for antibiotic prophylaxis for women undergoing Caesarean section.

Emergency C/S

Give the prophylaxis as outlined below EXCEPT for women who are already on Clindamycin for pyrexia in labour, these women require IV Gentamicin 1.5mg/kg stat to add gram negative cover.  If the woman has already received Gentamicin do not give another dose unless the last dose was more than 8 hours previously

To be started after clamping of the umbilical cord, unless there are reasons for commencing earlier (e.g. pyrexia in labour).

• Co-amoxiclav IV 1.2g (single dose)
• If non-severe penicillin allergy (e.g. mild rash only) and not at risk of endocarditis: Cefuroxime IV 1.5g and Metronidazole IV 500mg (single doses)
• If severe allergy to penicillins and/or cephalosporins Clindamycin IV 900mg (single dose)
• If penicillin allergy and high risk of endocarditis: IV Teicoplanin 400mg plus IV Gentamicin 1.5mg/kg plus IV Metronidazole 500mg (single doses)
• If previous MRSA infection or colonisation: IV Teicoplanin 400mg IV plus Gentamicin 1.5mg/kg and IV Metronidazole 500mg (single doses).

For a full copy of the guideline Click here.

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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