gynecology and obstetrics
Septic Abortion
Treatment of Septic Abortion
Intravenous empiric broad-spectrum antibiotic therapy (eg,clindamycinplusgentamicinwith or withoutampicillin) Uterine evacuation Sometimes pelvic or abdominal imaging Treatment of septic abortion includes intravenous broad-spectrum antibiotic therapy, which should be initiated immediately. Choice of antibiotics should take into consideration that infections are polymicrobial, and treatment should cover gram-positive, gram-negative, and anaerobic bacteria. A typical empiric antibiotic regimen includesclindamycin900 mg IV every 8 hours plusgentamicin5 mg/kg IV once a day, with or withoutampicillin2 g IV every 4 hours. Alternatively, a combination ofampicillin,gentamicin, andmetronidazole500 mg IV every 8 hours can be used. Antibiotic regimen may be modified based on culture results. In addition, uterine evacuation should be performed once the patient is stable. Patients with bleeding or suspected uterine perforation or organ damage may need further imaging (eg, MRI). 