C-section wound infection - Antibiotic Prescribing

Consider sepsis and refer to hospital if suspected.
These oral options are suitable for superficial incisional wound infections. For deep incisional or suspected organ space infections consider referral to the hospital for further assessment.

C-section Wound Infection Empiric Antibiotic Treatment Table
Drug	Dose	Duration	Notes
1st choice options
Co-amoxiclav	625mg every 8 hours	5-7 days*	Avoid in penicillin allergy
2nd choice options / Penicillin Allergy
Clindamycin	300mg - 450mg every 6 hours	5-7 days*	Caution: risk of C. difficile

* Where Group A Strep is identified on culture: duration of therapy to be extended to 10 days. Antibiotics should be started for BOTH mother and neonates within 28 days of delivery as soon as possible, even if asymptomatic. For management of neonates, please refer to HPSC Guidance on Management of invasive and non-invasive Group A Streptococcal infection for mothers and neonates within 28 days of delivery where the document is available to download.

An information sheet on ‘Antibiotics and breastfeeding' is available from the Breastfeeding Network UK
Further information on Antibiotics and Breast-feeding can be found on the Mother to Baby website (USA) (Search or Use Browse by Medications category).
HSE My Child is a useful resource for breastfeeding support and general guidance.

Doses are oral and for adults unless otherwise stated
Dosing in children quick reference dosage/weight guide
Penicillin allergy – tips on prescribing in penicillin allergy
Renal impairment dosing table
Safety in Pregnancy and Lactation
Drug interactions tables. Extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.
Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC).

Reviewed October 2024