Antibiotic therapy in time of labour – the Slovenian recomendations

  • Vesna Fabjan Vodušek Department of Perinatology, Division of Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Lilijana Kornhauser Cerar Department of Perinatology, Division of Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Helena Mole Paediatrics Helena Mole, Private paediatric clinic, Ljubljana, Slovenia
  • Barbara Šajina Stritar Department of Perinatology, Division of Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Marko Pokorn Department of Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Miha Lučovnik Department of Perinatology, Division of Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Nataša Tul Mandič Department of Perinatology, Division of Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
Keywords: Antibiotic prophylaxis, group B streptococci (GBS), Preterm labour, Preterm Premature Rupture of Membranes (PPROM), Recomendations

Abstract

Antibiotic agents are administered during the intrapartum period to prevent and treat maternal infection and to prevent neonatal disease. Short courses of antibiotics are used during the labour to prevent such infections as group B streptococci (GBS) in newborns, postpartum endometritis and to treat chorioamnionitis. Many trials have evaluated the use of prophylactic antibiotics to prolong the pregnancy (and subsequently improve neonatal outcomes) after premature rupture of membranes (PROM).                                                                                                           Intravenous antibiotics recommended for women in active preterm labour are:                       Penicillin G: given as 3g (or 5MU) intravenously at first and then 1.5g (or 2.5MU) at 4-hourly intervals until delivery.                                                                                                             For women allergic to penicillin: provided a woman has not had severe allergy to penicillin, a cephalosporin should be used. If there is any evidence of severe allergy to penicillin, vancomycin should be used.                                                                                                               For women allergic to penicillin, Clindamycin is no longer recommended as the current resistance rate is high.                                                                                                                         Where infection of the membranes is diagnosed or suspected or where there is preterm prolonged rupture of membranes, broad spectrum intravenous antibiotics should be given which include adequate GBS cover (we recomend Cefazolin 2g i.v and then 1g at 8-hourly intervals until delivery).                                                                                                                                           In PPROM we recomend as soon as possible after PPROM: ampicillin (2 g i.v. every 6 hours) for 48 hours plus azithromycin (1g p.o in onetime administration), followed by amoxicillin (500 mg p.o. every 8 hours) for 5 days unless delivery occurs.

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Published
2019-03-04
How to Cite
1.
Fabjan Vodušek V, Kornhauser Cerar L, Mole H, Šajina Stritar B, Pokorn M, Lučovnik M, Tul Mandič N. Antibiotic therapy in time of labour – the Slovenian recomendations. ZdravVestn [Internet]. 4Mar.2019 [cited 22Sep.2019];88(1-2):93-02. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2916
Section
Professional Article