Hesperian Health Guides

Medicines for Womb Infection

For mild fever during labor, ampicillin plus gentamicin will usually work. For high fever in labor, or for signs of infection after birth, use metronidazole as well to fight all the possible bacteria that can cause the infection. It is best to inject at least the first dose of ampicillin, but if you have only pills give those instead.

AMPICILLIN Inject 2 grams. Wait 6 hours, then inject or give by mouth 1 gram every 6 hours.
GENTAMICIN Inject 5 mg per kg, once a day. If you cannot weigh the woman, inject 80 mg, 3 times a day.
METRONIDAZOLE Give 500 mg by mouth, 3 times a day.

Give all 3 medicines until 2 days after signs of infection have stopped.
In case of allergy to penicillins, give 500 mg erythromycin 4 times a day instead of ampicillin. Other combinations of antibiotics can be given if they are all you have. Choose a combination that fights a wide-range of bacteria.


Ampicillin is a broad-spectrum penicillin, which means it kills many kinds of bacteria. You can often use it interchangeably with amoxicillin, that is, if this book or another resource suggests one of these medicines, you will often be able to use the other in its place, in the correct dose.
Ampicillin is very safe and especially helpful for infections during birth.

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Ampicillin tends to cause nausea and diarrhea.
The other common side effect is rash. But raised, itchy bumps that come and go in a few hours are probably a sign of penicillin allergy. Stop giving the medicine right away and do not give the person a penicillin medicine again. Future allergic reactions may be more severe and even life-threatening. For some problems, erythromycin can be used instead. A flat rash that looks like measles, usually starts a week after starting the medicine, and takes days to go away, is not necessarily an allergy. But it is impossible to know for sure if the rash is from allergy or not, so it is usually better to stop the medicine.


Resistance to this medicine is growing more common. Depending on where you live, it may not work any more against staphylococcus, shigella, or other infections.

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Ampicillin works well when taken by mouth. It can also be given by injection, but should be injected only for severe illnesses such as pelvic infection or womb infection, or when the person is vomiting or cannot swallow.
As with other antibiotics, always give the medicine for at least the shorter number of days shown here. If the person still has signs of infection, have her continue taking the same amount every day until all signs of infection have been gone for at least 24 hours. If the person has taken the medicine for the maximum number of days and is still sick, stop giving the antibiotic and get medical help.

Likewise, the amount of antibiotic to take depends on the age or weight of the person and the severity of the infection. In general, give the smaller amount for a thinner person or a less severe infection, and the larger amount for a heavier person or a more severe infection.
For womb infection
Give combined with other antibiotics and in the amount listed above.


Gentamicin is a very strong antibiotic of the aminoglycoside family. It can only be given by injection or IV (in the vein). This drug can damage the kidneys and the hearing, so it should only be used in emergencies.


Gentamicin must be given in the exactly correct dose. Giving too much can cause kidney damage or permanent deafness. It is best to dose by weight. And do not give gentamicin for more than 10 days.

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For womb infection
Give combined with the other antibiotics and in the amount listed above.


Metronidazole is effective at fighting certain bacteria and infections used by itself or in combination with other antibiotics.

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Nausea, cramps, and diarrhea are common. Taking with food may help. Sometimes it causes a metallic taste in the mouth or a headache.


Do not give metronidazole in the first 3 months of pregnancy because it may cause birth defects. Also avoid giving metronidazole later in pregnancy and while breastfeeding unless it is the only effective medicine and is definitely needed. Do not drink alcohol while taking metronidazole or until 2 days after you finish taking it. Drinking alcohol while taking metronidazole causes severe nausea Do not use metronidazole if you have liver problems.
Do not drink alcohol until 2 days after you finish taking this medicine. Mixing the two causes severe nausea. Do not use metronidazole if you have liver problems.

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For many conditions, you can give a high dose of this medicine for 3 days, or a lower dose for 5 to 10 days. Pregnant women should avoid the high dose treatments.

For womb infection
Give combined with the other antibiotics and in the amount listed above.

This page was updated:31 May 2018