To Name :
To Email :
From Name :
From Email :
Comments :

Comment and Controversy

What drug is best for penicillin-allergic women who undergo C-section?

August 2009 · Vol. 21, No. 08
This week's quiz:
More »


Dr. Duff’s recommendations for therapy are most helpful. He includes a recommendation for antibiotic prophylaxis in penicillin-allergic patients undergoing perineal repair, but not for women undergoing cesarean delivery. What is Dr. Duff’s recommendation in that case?

Jane Helwig, MD
Lancaster, SC

Dr. Duff responds:

A combination of drugs is recommended

Dr. Helwig poses a very thoughtful question. If a patient has an immediate, life-threatening allergy to beta-lactam antibiotics, she should not receive a cephalosporin antibiotic for prophylaxis. Rather, I would give a single dose of clindamycin (900 mg intravenously [IV]) plus gentamicin (1.5 mg/kg of actual weight, IV) plus azithromycin (500 mg IV). The first two drugs can be administered rapidly. However, azithromycin should be administered slowly over the course of 1 hour. We begin the infusions before surgery.

Did you miss this content?
Get smart about dense breasts