Infectious Diseases in Obstetrics and Gynecology

Review Article

Pelvic Surgical Site Infections in Gynecologic Surgery

Table 3

Recommended antibiotic regimen for pelvic infections after gynecologic surgery.
Infection typeAntimicrobialsDuration of treatment
Vaginal cuff cellulitisOral regimen
Amoxicillin/clavulanate 875/125 mg q 12 h
OR
Ciprofloxacin 500 mg q 12 h
PLUS
Metronidazole 500 mg q 12 h
OR
Trimethoprim/sulfamethoxazole
160/800 mg q 12 h
PLUS
Metronidazole 500 mg q 12 h		7–14 days
Pelvic cellulitis and pelvic abscesses[a]Parenteral regimens
Clindamycin 900 mg q 8 h or Metronidazole 500 mg q 12 h
PLUS
Ceftriaxone 2 g q 24 h
OR
Clindamycin 900 mg q 8 h or Metronidazole 500 mg q 12 h
PLUS
Penicillin 5 million u q 6 h or Ampicillin 2 g q 6 h
PLUS
Gentamicin 5 mg/kg IBW q 24 h
OR
Aztreonam 2 g q 8 h[b] 
Oral regimen
Metronidazole 500 mg q 12 h
PLUS
Trimethoprim/sulfamethoxazole
160/800 mg q 12 h
OR
Amoxicillin/clavulanate (875/125 mg q 12)		14 days
Parenteral antibiotics should be continued until the patient is afebrile for 24–48 hours. Patient should subsequently receive oral antibiotics to complete 14-day course of antibiotics.
[b]Aztreonam 2 g q 8 h may be substituted for gentamicin in patients who have renal impairment.