Guideline for antibiotic prophylaxis for women in labour with known heart valve disease and for routine prophylaxis for women

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Guideline for antibiotic prophylaxis for women in labour with known heart valve disease and for routine prophylaxis for women undergoing Caesarean section.

Women undergoing delivery by Caesarean section: Group B streptococcus carrier.

Antibiotics:

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 stat
If penicillin-allergy: Cefuroxime IV 750mg + Metronidazole IV 500mg stat.

Known carriers of Group B streptococcus with ruptured membranes of 4 hours duration or more but who end up with Caesarean section should receive:

Antibiotics as detailed above at the operative delivery.
IN ADDITION TO antibiotics as detailed in the ruptured membranes guide:
- Benzylpencillin IV 2.4g initially followed by 1.2g 4 hourly
- If penicillin-allergic, Clindamycin IV 900mg 8 hourly

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.