Antibiotic treatment for pelvic infection.

Antibiotic strategies for pelvic infections in the 1980s are much more complex, because of the variety of bacteria involved, aerobes, anaerobes and Chlamydia. There is a difference in the clinical response of patients treated with early or well-established infections. In well established infections, patients with a pelvic mass or symptoms greater than five days, the failure rate of antibiotic treatment is higher and operative intervention to drain or remove an abscess is more frequently needed. Physicians need to know the antibiotic susceptibilities of Bacteroides fragilis and the activity of antibiotics against this species when large numbers of bacteria are present. In patients seen early in the course of infection, antibiotics effective against gram-negative anaerobes are helpful, particularly in the patient with an endomyometritis following cesarean section.