title: Sulbactam/ampicillin versus metronidazole/gentamicin in the treatment of post-cesarean section endometritis.
abstract: Sixty-seven patients diagnosed with post-cesarean-section endometritis were studied in a prospective comparative randomized trial of sulbactam/ampicillin, a new beta-lactamase inhibitor drug combination, versus treatment with metronidazole/gentamicin. The success rate was 91% for each antibiotic regimen. Mycoplasma spp. or Ureaplasma spp. were isolated from all treatment failures. Endometrial cultures revealed 2.3 aerobes as well as anaerobes per patient, with Enterococcus faecalis, Bacteroides bivius, and Escherichia coli the most frequently reported bacterial isolates in 64, 40, and 28% of all patients, respectively. Positive blood cultures were noted in 11 (15%) patients with Mycoplasma sp. the most commonly found isolate (45.5%). Sulbactam/ampicillin appears to be safe and equally effective as a metronidazole/aminoglycoside drug regimen in the treatment of postpartum endometritis.
authors.affiliation: Department of Obstetrics-Gynecology, Baylor College of Medicine, Houston, Texas 77030.
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; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology; D002585:Cesarean Section / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D004716:Endometritis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage; D011247:Pregnancy; D011446:Prospective Studies; D011645:Puerperal Infection / Q000188:drug therapy* / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D013407:Sulbactam / Q000008:administration & dosage
chemical_list: D005839:Gentamicins; D008795:Metronidazole; C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam