Clinical experience with cefotaxime in obstetric and gynecologic infections.

Infections in the upper genital tract continue to be one of the leading causes of serious morbidity for obstetric and gynecologic patients. The polymicrobial, mixed aerobic and anaerobic isolates recovered from women with such infections demand broad-spectrum antimicrobial activity. In the past, combination therapy has been given in order to attain this coverage. In a multicenter open study, cefotaxime was used for treatment of endomyometritis after cesarean section, pelvic cellulitis after hysterectomy, and acute pelvic inflammatory disease. The drug effected a clinical cure in 93% of 104 women. In a randomized comparative study conducted at one center, cefotaxime cured 97% of 36 cases of post-cesarean section endomyometritis; clindamyclin plus gentamicin cured 94% of 18 cases of the same infection. There was no evidence of significant alteration in hematopoietic, hepatic, or renal function with either regimen. Cefotaxime appears to be a safe, extremely effective antimicrobial drug that is ideally suited for single-agent treatment of serious soft-tissue pelvic infections in obstetric or gynecologic patients.