Time to antibiotic initiation for suspected chorioamnionitis and factors associated with delayed treatment.

Intraamniotic infection can be associated with maternal bacteremia in 10% of cases. 1 Tita AT Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol. 2010; 37: 339-354 Abstract Full Text Full Text PDF PubMed Scopus (520) Google Scholar Prompt initiation of antibiotic treatment is critical to prevent maternal and fetal complications. 2 Committee Opinion No. 712: intrapartum management of intraamniotic infection. Obstet Gynecol. 2017; 130: e95-e101 Crossref PubMed Scopus (171) Google Scholar At our quaternary center, the primary antibiotic regimen for suspected chorioamnionitis is ampicillin plus gentamicin. 2 Committee Opinion No. 712: intrapartum management of intraamniotic infection. Obstet Gynecol. 2017; 130: e95-e101 Crossref PubMed Scopus (171) Google Scholar A preliminary quality improvement (QI) initiative evaluating the time from fever onset to antibiotic (ie, ampicillin and gentamicin) initiation in laboring patients at our institution suggested frequent delays of ≥1 hour for gentamicin. The aim of the present QI study was to determine the time to gentamicin treatment and specific factors associated with delayed gentamicin administration among patients with a new diagnosis of suspected chorioamnionitis.