The treatment of endomyometritis.

The mainstay of treatment for postpartum endometritis is a combination of antibiotics, such as clindamycin plus an aminoglycoside. In an effort to save time and reduce the cost of treating this infection, researchers have investigated monotherapy with a beta-lactam antibiotic. Twenty-five patients with postcesarean endometritis and three with postpartum endometritis were studied at two sites for the effectiveness of 3.1 g ticarcillin disodium/clavulanate potassium administered every four or six hours for a minimum of four days. Eighteen of the 25 postcesarean endometritis patients (72%) were judged clinical cures, 6 (24%) were clinical failures, and 1 had therapy discontinued because of diarrhea. In the postpartum course of all the patients there were no wound infections and three (12%) instances of bacteremia. The majority of the enterococci were sensitive to ticarcillin disodium/clavulanate potassium, as were all of the Escherichia coli, Klebsiella pneumoniae, Bacteroides bivius, Bacteroides fragilis and other Bacteroides species.