Enterococci in post-cesarean endometritis.
Three hundred eleven patients with post-cesarean endometritis were treated with clindamycin and gentamicin. Isolation of enterococci in the endometrium was associated with use of cephalosporin prophylaxis (P less than .001). Other risk factors for enterococcus-associated endometritis included increased numbers of vaginal examinations (P = .018) and increased length of internal monitoring (P = .006). Patients with enterococcus-associated endometritis were less likely to respond to therapy with clindamycin and gentamicin than were patients without enterococci (82.4 versus 92.7%, respectively; P = .015). Patients with enterococcus-associated endometritis also were significantly more likely to have wound infection (15.7 versus 3.2%, respectively; P = .001). In a retrospective survey of 14 patients with postpartum enterococcal bacteremias, four (29%) had a poor response to initial therapy.
Walmer
D
D
Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio.
Walmer
K R
KR
Gibbs
R S
RS
D002585:Cesarean Section / Q000009:adverse effects*; D002981:Clindamycin / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004716:Endometritis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D004717:Endometrium / Q000382:microbiology; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011645:Puerperal Infection / Q000188:drug therapy / Q000382:microbiology*; D013291:Streptococcus / Q000302:isolation & purification*
D005839:Gentamicins; D002981:Clindamycin