Yonekura M L
Harbor-UCLA Medical Center, Torrance 90509.
Clin Obstet Gynecol. 1988 Jun;31(2):488-500. doi: 10.1097/00003081-198806000-00023.
Improved understanding of the microbiology of postcesarean endometritis has dramatically changed the approach to its antibiotic therapy. Initial therapy should include broad-spectrum anaerobic coverage, including against all Bacteroides species, as well as gram-positive and gram-negative aerobic coverage. Moreover, ideally initial therapy should also include coverage of Chlamydia trachomatis. Furthermore, although the use of antibiotic prophylaxis for high-risk patients undergoing cesarean section has significantly decreased their incidence of febrile morbidity, one must remember that prophylactic antibiotics have important bacteriologic effects that may limit the efficacy of monotherapy for the treatment of endometritis in prophylaxis failures.
对剖宫产术后子宫内膜炎微生物学的深入了解极大地改变了其抗生素治疗方法。初始治疗应包括广谱厌氧菌覆盖，包括针对所有拟杆菌属物种，以及革兰氏阳性和革兰氏阴性需氧菌覆盖。此外，理想情况下初始治疗还应包括沙眼衣原体覆盖。此外，尽管对剖宫产高危患者使用抗生素预防已显著降低了其发热性疾病的发生率，但必须记住，预防性抗生素具有重要的细菌学效应，这可能会限制在预防失败时单一疗法治疗子宫内膜炎的疗效。
