A comparative study of two antibiotic regimens for the treatment of operative site infections

• Published in: American journal of obstetrics and gynecology Vol. 142; no. 8; p. 996
• Main Authors: Duff, P, Keiser, J F
• Format: Journal Article
• Language: English
• Published: United States 15-04-1982
• Subjects: Bacterial Infections - drug therapy; Cefoxitin - therapeutic use; Cesarean Section - adverse effects; Clindamycin - therapeutic use; Clinical Trials as Topic; Delivery, Obstetric; Drug Therapy, Combination; Endometritis - drug therapy; Endometritis - microbiology; Female; Gentamicins - administration & dosage; Humans; Hysterectomy - adverse effects; Infant, Newborn; Parametritis - drug therapy; Parametritis - microbiology; Penicillins - administration & dosage; Peptococcus - isolation & purification; Postoperative Complications - drug therapy; Postoperative Complications - microbiology; Pregnancy; Prospective Studies; Puerperal Infection - drug therapy; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Streptococcus agalactiae - isolation & purification
• ISSN: 0002-9378
• DOI: 10.1016/0002-9378(82)90782-7

This prospective study was designed to compare the relative efficacy of two antibiotic regimens for the treatment of operative site infections subsequent to pelvic operations. Patients with endomyoparametritis after delivery or pelvic cellulitis subsequent to hysterectomy were randomized to treatment with the combination of penicillin-gentamicin or the single agent cefoxitin. Seventeen of the 26 patients (65%) with endomyoparametritis who were treated with penicillin-gentamicin were cured by antibiotic therapy alone, in comparison to 15 of 23 (65%) patients treated with cefoxitin. Fifty-eight percent of the patients with pelvic cellulitis who were treated with penicillin-gentamicin responded favorably, in comparison to 50% of the patients treated with cefoxitin. None of these differences was statistically significant. In this study, neither antibiotic regimen provided satisfactory initial treatment for surgically induced soft tissue pelvic infection. Moreover, 11 of the 28 patients with treatment failures (40%) developed serious sequelae of their primary infection.