Postpartum endometritis: efficacy and tolerability of two antibiotic regimens.
A prospective, multicenter, open-label randomized trial was conducted to compare the efficacy and tolerability of imipenem-cilastatin (I-C) monotherapy with clindamycin+aminoglycoside (C+A) combination therapy. Forty-nine patients were able to be evaluated for clinical efficacy in the treatment of postpartum endometritis. Twenty-three patients received I-C and 26 received C+A therapy. The two groups were statistically similar for demographic and clinical variables upon entry into the study. The results of therapy were categorized as cured, improved, or failed. The use of I-C resulted in an overall clinical response rate (cured and improved) of 91%, compared with an overall response rate with C+A of 73% (P = 0.15). Patients categorized as improved comprised 56.5% of those in the I-C group and 38.5% of those in the C+A group. Patients categorized as failed comprised 8.7% of those in the I-C group and 26.9% of those in the C+A group. Overall, these data support the use of I-C for the treatment of appropriate patients with postpartum endometritis.
Gonik
B
B
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School, Houston.
D000328:Adult; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015377:Cilastatin / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use; D004716:Endometritis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D015378:Imipenem / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011645:Puerperal Infection / Q000188:drug therapy*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D015377:Cilastatin; D015378:Imipenem