Postpartum Endometritis

Think sepsis for all patients who have recently delivered a baby who feel unwell or have pyrexia or hypothermia with uterine tenderness. If there are signs of sepsis refer to hospital urgently.
Where postpartum endometritis is suspected, consider referral for admission.
Postpartum endometritis can occur concomitantly with C-Section wound infection.
For non-pregnancy-related acute endometritis see Pelvic Inflammatory Disease

Postpartum Endometritis Empiric Antibiotic Treatment Table
Drug	Dose	Duration	Notes
1st choice option
Co-amoxiclav	625 mg every 8 hours	10 days	Avoid in penicillin allergy
2nd choice option / Penicillin Allergy
Clindamycin	300 mg - 450 mg every 6 hours	10 days	Caution: Risk C. diff

Visit HSE My Child website for further information.
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).

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 table.
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 December 2024