GBS prophylaxis (intrapartum)
- ›Benzylpenicillin 3 g IV loading → 1.5 g IV every 4 h until delivery.
- ›Penicillin allergy (non-severe): cefuroxime 1.5 g IV loading → 750 mg q8h.
- ›Severe allergy: vancomycin 1 g IV q12h (measure levels).
PID (outpatient)
- ›Ceftriaxone 1 g IM single dose + doxycycline 100 mg PO BD for 14 d + metronidazole 400 mg PO BD for 14 d.
- ›Pregnancy: replace doxycycline with azithromycin/erythromycin.
Chorioamnionitis
- ›IV amoxicillin 2 g q6h + gentamicin 5 mg/kg once daily + metronidazole 500 mg IV q8h.
- ›Continue until 24 h afebrile.
Endometritis (postpartum)
- ›Clindamycin 900 mg IV q8h + gentamicin 5 mg/kg OD until 24 h afebrile.
- ›Add ampicillin if enterococcal cover needed.
UTI in pregnancy
- ›First line: nitrofurantoin 100 mg BD 7 d (AVOID after 36/40 & at term).
- ›Alternative: cefalexin 500 mg TDS 7 d, or amoxicillin 500 mg TDS if sensitive.
- ›Avoid trimethoprim in T1 (folate antagonist).
Mastitis
- ›Flucloxacillin 500 mg QDS 10–14 d. Continue breastfeeding.
- ›Allergy: erythromycin 250–500 mg QDS.
Common mistakes
- •Giving nitrofurantoin at term → neonatal haemolysis.
- •Trimethoprim in T1 → NTDs; safe in T2/T3 if needed.
- •Doxycycline in pregnancy → dental staining, growth inhibition.
- •Metronidazole 'avoided' myth — safe throughout pregnancy at standard doses.