INTRAVENOUS METRONIDAZOLE OR CLINDAMYCIN WITH TOBRAMYCIN FOR THERAPY OF PELVIC INFECTIONS

  • 1 January 1981
    • journal article
    • research article
    • Vol. 57  (1) , 51-58
Abstract
Anaerobic bacteria are important pathogens in obstetric and gynecologic infections. As metronidazole [M] has excellent in vitro activity against almost all clinically significant anaerobes, the newly available parenteral form of the drug was evaluated in a comparative study with clindamycin [C]. Patients (47) with postpartum endomyometritis with or without wound infection, acute or chronic salpingo-oophoritis, tuboovarian abscess, postoperative pelvic cellulitis or wound infection, or other soft-tissue infection were included in the study. Initially 6 patients were treated with metronidazole, usually combined with tobramycin [T], in an open study. Subsequently, 41 patients were treated on a randomized schedule of either M or C, each combined with T. Anaerobic bacteria were isolated from 86% (37 of 43) of the patients who had positive cultures from sites cultured for aerobes and anerobes. Anaerobic gram-negative rods and gram-positive cocci were the predominant isolates from infected tissues. Of the patients who received M, 96% (25 of 26) were considered clinically cured; the remaining patient initially responded but continued to have slight temperature elevations. There were no adverse reactions to this drug. Of the patients who received C, 100% were considered clinically cured. The excellent therapeutic response to i.v. M and the predominance of pathogenic anaerobes observed in these infections support its use in the treatment of infections of the female genital tract.

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