title: Ampicillin/sulbactam versus clindamycin in the treatment of postpartum endomyometritis.
abstract: Sixty-eight patients with postpartum endomyometritis were enrolled in this open randomized comparative study. Forty-two patients received ampicillin/sulbactam and 26 received clindamycin. The cure rates were similar in the two groups: 83% in the ampicillin/sulbactam group and 88% in the clindamycin group. The most frequent endometrial bacterial isolates were Bacteroides bivius, Streptococcus faecalis, Escherichia coli, and Ureaplasma urealyticum. Bacteremia was present in 15 of 68 (22%), the most frequent isolates being Mycoplasma (four cases) and B bivius (three cases). Clindamycin-resistant species were S faecalis, E coli, and Proteus mirabilis. There were seven treatment failures in the ampicillin/sulbactam group; only one isolate (an E coli) was resistant to ampicillin/sulbactam. In a significant number of these failures, Mycoplasma was isolated. Ampicillin/sulbactam and clindamycin were found to be equally efficacious in the treatment of postpartum endometritis.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Tex.
authors.forename: M G
authors.initials: MG
authors.lastname: Martens
authors.forename: S
authors.initials: S
authors.lastname: Faro
authors.forename: H A
authors.initials: HA
authors.lastname: Hammill
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: G
authors.initials: G
authors.lastname: Riddle
authors.forename: M
authors.initials: M
authors.lastname: Maccato
mesh_terms: D000328:Adult; D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D000668:Ampicillin Resistance; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy*; D002981:Clindamycin / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004716:Endometritis / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D011645:Puerperal Infection / Q000175:diagnosis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D013407:Sulbactam / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D002981:Clindamycin; D000667:Ampicillin; D013407:Sulbactam