Anaerobic coverage for intra-amnionic infection: maternal and perinatal impact.
Although intrapartum antibiotics are beneficial to both the mother and newborn, there is no consensus as to the most efficacious antibiotic regimen in the treatment of intra-amnionic infection, especially with regard to anaerobic coverage. We randomized pregnant women with intra-amnionic infection to receive either dual agent therapy (ampicillin and gentamicin) or triple agent therapy (ampicillin, gentamicin, and clindamycin). The frequency of vaginal and cesarean delivery was similar in both groups. There was no significant difference in the incidence of endometritis between the two groups (10 of 69 versus 5 of 64; p = NS). There were no significant differences in either neonatal morbidity or mortality. The addition of clindamycin to provide anaerobic coverage for intra-amnionic infection does not significantly alter the incidence of endometritis in women delivered by cesarean section, although it may have an impact on women delivering vaginally.
Maberry
M C
MC
Department of Obstetrics & Gynecology, University of Texas Southwestern Medical Center, Dallas 75235-9032.
Gilstrap
L C
LC
Bawdon
R
R
Little
B B
BB
Dax
J
J
D000667:Ampicillin / Q000627:therapeutic use*; D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000188:drug therapy*; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000188:drug therapy* / Q000382:microbiology; D002981:Clindamycin / Q000627:therapeutic use*; D036861:Delivery, Obstetric; D004359:Drug Therapy, Combination; D004716:Endometritis / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology
D005839:Gentamicins; D002981:Clindamycin; D000667:Ampicillin