Comparative evaluation of clindamycin versus clindamycin plus tobramycin in the treatment of acute pelvic inflammatory disease.
Fifty-one hospitalized women were treated with either clindamycin phosphate alone (N = 23) or a combination of clindamycin phosphate plus tobramycin (N = 28) for community-acquired pelvic inflammatory disease. The overall regimen clinical success rates were 100 and 91% for the clindamycin/tobramycin and clindamycin-alone groups, respectively. Efficacy for patients with positive pre-treatment Neisseria gonorrhoeae cultures was eight of eight (100%) for the clindamycin/tobramycin group and seven of eight (88%) in the clindamycin-alone group. Of the total population studied, 15 of 51 (29%) had positive pre-treatment cultures for Chlamydia trachomatis, and a microbiologic cure was attained in 15 of 15 (100%). However, in two of 15 (14.5%), the patient did not return for the 6-week culture, although the culture at discharge from the hospital was negative. No serious adverse reactions were observed, although oral follow-up treatment with clindamycin had to be discontinued in one patient because of diarrhea, which resolved without additional therapy. The results suggest that intravenous clindamycin alone is a viable alternative to the use of clindamycin/tobramycin for women with acute pelvic inflammatory disease requiring hospitalization.
Department of Obstetrics and Gynecology, University of Louisville College of Medicine, Kentucky.
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D000293:Adolescent; D000328:Adult; D001202:Ascitic Fluid / Q000382:microbiology; D002690:Chlamydia Infections / Q000188:drug therapy; D002692:Chlamydia trachomatis; D002981:Clindamycin / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D009175:Mycoplasma Infections / Q000188:drug therapy; D009180:Mycoplasmatales Infections / Q000188:drug therapy; D000292:Pelvic Inflammatory Disease / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D014031:Tobramycin / Q000009:adverse effects / Q000627:therapeutic use*; D014509:Ureaplasma
D002981:Clindamycin; D014031:Tobramycin