Pregnancy and Post Partum Infections

Mastitis

Comment:

Note higher doses of antibiotics are required in mastitis treatment to ensure adequate tissue penetration. Low dose i.e 250mg or TDS may result in treatment failure.
The patient should be encouraged to either breastfeed or express to ensure milk stasis does no occur. Cold compresses and analgesia should be used 

Treatment:

  1. First line Flucloxacillin 500mg-1g QDS PO x 5-7 days
  2. Second line or penicillin allergy Clindamycin 300-450mg QDS PO x 5-7 days

Endometritis

The patient should be examined closely in case of sepsis due to retained products of conception

Treatment

  1. First line Co-amoxiclav 625mg TDS PO x 10 days
  2. Second line or penicillin allergy Clindamycin 300-450mg QDS PO x 10 days

Perineal wound infection

The patient should be advised regarding correct hygiene of the perineum, particularly following episiotomy.

Treatment

  1. First line Co-amoxiclav 625mg TDS PO x 7-10 days
  2. Second line or penicillin allergy Clindamycin 300-450mg QDS PO x 7-10 days

C-section wound infection

These oral options are suitable for superficial incisional wound infections. For deep incisional or suspected organ space infections consider referral to the hospital for further assessment.

Treatment

  1. First line Co-amoxiclav 625mg TDS PO x 7 days
  2. Second line or penicillin allergy Clindamycin 300-450mg QDS PO x 7 days

Nipple and breast thrush

  1. First line Topical miconazole should be given to the mother and baby. Apply cream to the breast and gel for the baby, but the gel should be smeared in the mouth and never given by spoon or syringe.
  2. Second line systemic fluconazole should only be used in exceptional circumstances and under medical supervision for deep candida mastitis which is very rare. There is a significant risk of drug interactions and caution must be exercised when using fluconazole

UTI in Pregnancy

Click here to view the UTI in Pregnancy page


Influenza

The patient should be referred to hospital for assessment if there is any respiratory compromise or suspicion of a bacterial super-infection

Treatment

Oseltamavir 75mg BD PO x 5 days


Patient Information

Visit HPSC Information Leaflets pages for the General Public, (MRSA, CRE, etc)


Prescribing Antimicrobial in Pregnancy and Lactation

Prescribing Antimicrobial in Pregnancy and Lactation


Reviewed August 2017

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