Document Detail


Treatment of post-cesarean section endometritis with ampicillin and sulbactam or clindamycin and gentamicin.
MedLine Citation:
PMID:  8277478     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Seventy-seven patients were prospectively enrolled in a randomized clinical trial to compare two antimicrobial regimens for the treatment of post-cesarean section endometritis. The two groups were not significantly different with respect to age, race, gravidity, parity, hours in labor, cesarean section indication, preoperative or postoperative hemoglobin/hematocrit, pretreatment white blood cell count or pretreatment temperature. Pretreatment urine, blood and endometrial cultures were obtained. One or more organisms was recovered from the endometrium in 90% of the patients using a double-lumen sampling device. The most frequent endometrial isolates were Peptostreptococcus and Bacteroides species, followed by Gardnerella vaginalis and enterococci. Thirty (81%) of 37 patients receiving ampicillin/sulbactam and 33 (83%) of 40 receiving gentamicin and clindamycin responded to therapy. There were 14 (18%) treatment failures, 7 in each group. Five (36%) of the 14 clinical failures were due to septic pelvic thrombophlebitis, 2 (14%) of the 14 failures were complications of intraabdominal abscesses, and the remaining 7 patients responded after a change in their antibiotic regimen. We conclude that ampicillin/sulbactam and clindamycin/gentamicin are similarly effective for the treatment of post-cesarean section endometritis.
Authors:
T G Stovall; E M Thorpe; F W Ling
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  38     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1994-02-07     Completed Date:  1994-02-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  843-8     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Ampicillin / therapeutic use
Bacteria / isolation & purification
Cesarean Section*
Clindamycin / therapeutic use
Drug Therapy, Combination / therapeutic use*
Endometritis / drug therapy*,  microbiology
Endometrium / microbiology
Female
Gentamicins / therapeutic use
Humans
Postoperative Complications / drug therapy*
Pregnancy
Prospective Studies
Puerperal Infection / drug therapy*
Sulbactam / therapeutic use
Chemical
Reg. No./Substance:
0/Gentamicins; 18323-44-9/Clindamycin; 68373-14-8/Sulbactam; 69-53-4/Ampicillin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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