Susceptibility of female pelvic pathogens to oral antibiotic agents in patients who develop postpartum endometritis.

Fifteen hundred patients were enrolled in a prospective, randomized study on the effect of antibiotic prophylaxis during cesarean section. Two hundred thirty-one patients developed postpartum endometritis, and the isolates obtained from the endometrium were tested for sensitivity to ampicillin, cefuroxime, ofloxacin, ciprofloxacin, and clindamycin. Minimum inhibitory concentrations of 50% and 90% of ampicillin, cefuroxime, and clindamycin were similar to previously reported values; however, slight differences were noted in the activity of the two quinolones to common pelvic isolates. The minimum inhibitory concentrations of 90% of ofloxacin and ciprofloxacin to 119 isolates of Enterococcus faecalis were 4.0 and 2.0, to 17 isolates of Staphylococcus aureus 1.0 and 0.5, to 39 isolates of Escherichia coli 0.5 and 1.0, to 46 isolates of Bacteroides bivius 4.0 and 8.0, to 57 isolates of Gardnerella vaginalis 1.0 and 2.0, to 71 isolates of Staphylococcus epidermidis 0.5 and 0.5, to 16 isolates of Proteus mirabilis 0.25 and 0.12, and to 50 isolates of Lactobacillus species 32.0 and 8.0 micrograms/ml, respectively. In summary, the quinolones have activity comparable with a variety of other oral agents versus female pelvic pathogens, with the quinolones ofloxacin and ciprofloxacin having better activity against most of the gram-negative isolates. Anaerobic activities were comparable with the beta-lactams, but inferior to clindamycin and metronidazole as expected.

RCT Entities:   Population Interventions Outcomes