3rd & 4th degree perineal tear
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 |