Puerperal infection after cesarean delivery: evaluation of a standardized protocol.

Autor:	Brumfield, Cynthia G., Hauth, John C., Brumfield, C G, Hauth, J C, Andrews, W W
Předmět:	ENDOMETRIAL diseases CESAREAN section complications GENTAMICIN CLINDAMYCIN VANCOMYCIN THERAPEUTICS DIAGNOSIS of endometrial diseases ANTIBIOTICS AMPICILLIN CESAREAN section COMBINATION drug therapy DRUG resistance in microorganisms FEVER LEUCOCYTE disorders PUERPERAL disorders SURGICAL complications TACHYCARDIA
Zdroj:	American Journal of Obstetrics & Gynecology; May2000, Vol. 182 Issue 5, p1147-1151, 5p, 1 Diagram
Abstrakt:	Objective: Our goal was to evaluate an antibiotic protocol for treatment of postcesarean endometritis.Study Design: Endometritis was diagnosed as a persistent fever > or =100.4 degrees F beyond 24 hours after cesarean delivery and one or more of the following: uterine tenderness, tachycardia, foul lochia, or leukocytosis. Antibiotic therapy included gentamicin plus clindamycin and ampicillin (or vancomycin) as a triple antimicrobial in 148 women. Antibiotic failure was defined as persistent fever after 5 days of antibiotics and 72 hours of triple antibiotics.Results: Between 1993 and 1996, 322 of 1643 (20%) women were diagnosed with postcesarean endometritis. One hundred seventy-four patients (54%) were cured with clindamycin-gentamicin, and 129 who additionally received ampicillin or vancomycin (40%) were cured. Nineteen of the 322 (6%) women had persistent fever despite triple antibiotics. Of these, 6 had a wound complication, 12 were suspected to have antimicrobial resistance, and 1 had an infected hematoma.Conclusion: A prospective protocol consisting of clindamycin-gentamicin plus the selective addition of ampicillin or vancomycin cured 303 of 322 (94%) women with postcesarean endometritis. [ABSTRACT FROM AUTHOR]
Databáze:	Supplemental Index
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