What is the standard drug treatment in the mother with chorioamnionitis?

Updated: May 08, 2018
  • Author: Fayez M Bany-Mohammed, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Early delivery, supportive care, and antibiotic administration for the mother with chorioamnionitis are discussed in Medical Care. The antibiotics used most often to treat mothers with acute chorioamnionitis are also discussed here. [1]

The treatment of the potentially septic neonate is complex. An overview of the treatment for early-onset neonatal infection is summarized in Medical Care.

Maternal antibiotics for chorioamnionitis

The standard drug treatment in the mother with chorioamnionitis includes ampicillin and an aminoglycoside (ie, usually gentamicin), although clindamycin may be added for anaerobic pathogens. [30] Cefazolin may be used instead of ampicillin for mothers with mild penicillin allergy and clindamycin or vancomycin may be used when infected mothers may be suffering from severe penicillin allergy. In cases involving premature labor or prelabor premature rupture of membranes (PPROM), penicillin or ampicillin is frequently administered as a chemotherapeutic agent to prevent group B streptococcal (GBS) colonization of the fetus. The use of penicillin alone is suggested for GBS chemoprophylaxis during the intrapartum period. Using penicillin rather than ampicillin may avoid colonization of the fetus with ampicillin-resistant E coli. The rationale for ampicillin use when maternal chorioamnionitis is suspected is that ampicillin would treat GBS, Haemophilus species, many enterococci strains, and Lmonocytogenes.

For more information on intrapartum antibiotic use to prevent GBS, see the Medscape Drugs and Diseases topic Bacterial Infections and Pregnancy.

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