Martens M G, Faro S, Hammill H A, Smith D, Riddle G, Maccato M
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Tex.
South Med J. 1990 Apr;83(4):408-13. doi: 10.1097/00007611-199004000-00012.
Sixty-eight patients with postpartum endomyometritis were enrolled in this open randomized comparative study. Forty-two patients received ampicillin/sulbactam and 26 received clindamycin. The cure rates were similar in the two groups: 83% in the ampicillin/sulbactam group and 88% in the clindamycin group. The most frequent endometrial bacterial isolates were Bacteroides bivius, Streptococcus faecalis, Escherichia coli, and Ureaplasma urealyticum. Bacteremia was present in 15 of 68 (22%), the most frequent isolates being Mycoplasma (four cases) and B bivius (three cases). Clindamycin-resistant species were S faecalis, E coli, and Proteus mirabilis. There were seven treatment failures in the ampicillin/sulbactam group; only one isolate (an E coli) was resistant to ampicillin/sulbactam. In a significant number of these failures, Mycoplasma was isolated. Ampicillin/sulbactam and clindamycin were found to be equally efficacious in the treatment of postpartum endometritis.
68例产后子宫内膜炎患者纳入了这项开放性随机对照研究。42例患者接受了氨苄西林/舒巴坦治疗，26例接受了克林霉素治疗。两组的治愈率相似：氨苄西林/舒巴坦组为83%，克林霉素组为88%。最常见的子宫内膜细菌分离株为双路拟杆菌、粪肠球菌、大肠埃希菌和解脲脲原体。68例中有15例（22%）发生菌血症，最常见的分离株为支原体（4例）和双路拟杆菌（3例）。对克林霉素耐药的菌株为粪肠球菌、大肠埃希菌和奇异变形杆菌。氨苄西林/舒巴坦组有7例治疗失败；只有1株分离菌（1株大肠埃希菌）对氨苄西林/舒巴坦耐药。在这些失败病例中，相当一部分分离出了支原体。结果发现，氨苄西林/舒巴坦和克林霉素在治疗产后子宫内膜炎方面同样有效。
