Operative vaginal delivery

Common Pathogens

Enterobacterales
Anaerobes
Group B Streptococci
Enterococcus spp

 

Regimen(s) of Choice
See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration
Cefazolin 2g IV x 1 pre-op dose
+    
Metronidazole 500mg PO  x 1 pre-op dose

 

Alternative Regimens if allergy to cefazolin, or severe non-IgE-mediated reaction to any β-lactam (interstitial nephritis, hepatitis, hemolytic anemia, serum sickness, severe cutaneous reactions [e.g. SJS, TEN, DRESS])
NB: Dosing prior to skin incision more effective than dosing after cord clamping.
Gentamicin 1.5mg/kg IV x 1 pre-op dose
+    
Clindamycin 600mg IV x 1 pre-op dose