Antibiotic therapy of endometritis following cesarean section. Treatment successes and failures.
A prospective clinical and microbiologic study was carried out on 413 indigent patients undergoing cesarean section. Operative site infection developed in 160 (38.5%). Initial treatment with penicillin and kanamycin was successful in 125 of these 160 infections (78%). Thirty-five patients (22%) failed to respond to penicillin and kanamycin and were treated with clindamycin or chloramphenicol. Twenty-eight of the 35 responded promptly to the additional antibiotic therapy. The remaining 7 patients (4%) had either abscesses, hematomas, or presumed septic pelvic thrombophlebitis. Among patients with anaerobic cultures, B fragilis was isolated with 12% with a good response to penicillin-kanamycin, but from 53% with a poor response to penicillin-kanamycin and with a good response to clindamycin or chloramphenicol. Similar critical evaluations of other antibiotic regimens are needed.
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001442:Bacteroides Infections / Q000188:drug therapy; D001441:Bacteroides fragilis / Q000187:drug effects / Q000302:isolation & purification; D002585:Cesarean Section; D002701:Chloramphenicol / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004716:Endometritis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007612:Kanamycin / Q000627:therapeutic use; D010400:Penicillin G / Q000627:therapeutic use; D011247:Pregnancy; D011446:Prospective Studies; D011645:Puerperal Infection / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D007612:Kanamycin; D002701:Chloramphenicol; D010400:Penicillin G