Ledger W J
Rev Infect Dis. 1983 Mar-Apr;5 Suppl 1:S98-104. doi: 10.1093/clinids/5.supplement_1.s98.
Evaluation of the treatment of 501 patients with pelvic infections and a review of the literature indicate that prospects for clinical cure without surgical intervention are markedly better in women seen early in the course of infection than in those with well-established infections. Among hospitalized patients with early infections, treatment regimens of less than 10 days duration were successful. Traditional therapies (initial treatment with ampicillin, a first-generation cephalosporin, or a combination of penicillin and aminoglycoside, penicillin and tetracycline, or a cephalosporin and an aminoglycoside, followed by clindamycin or chloramphenicol if the patient remained febrile) were compared with new antibiotic regimens (initial treatment with second- or third-generation cephalosporins). Among patients with an infected abortion, the results of treatment with traditional regimens were excellent. In patients with salpingo-oophoritis, the immediate cure rates with second- and third-generation cephalosporins were better than those with traditional regimens, but the long-term impact of these drugs on fallopian tube patency is not known. In women with postpartum endomyometritis following cesarean section, double-drug therapy with clindamycin and either gentamicin or ampicillin and single-drug therapy with a second- and third-generation cephalosporin were more effective than traditional therapy.
对501例盆腔感染患者的治疗评估及文献回顾表明，在感染病程早期就诊的女性中，未经手术干预而实现临床治愈的前景明显优于那些感染已确立的女性。在早期感染的住院患者中，疗程少于10天的治疗方案是成功的。将传统疗法（初始用氨苄西林、第一代头孢菌素，或青霉素与氨基糖苷类、青霉素与四环素、或头孢菌素与氨基糖苷类联合治疗，若患者仍发热则继以克林霉素或氯霉素治疗）与新抗生素方案（初始用第二代或第三代头孢菌素治疗）进行了比较。在感染性流产患者中，传统方案的治疗效果极佳。在输卵管卵巢炎患者中，第二代和第三代头孢菌素的即刻治愈率优于传统方案，但这些药物对输卵管通畅性的长期影响尚不清楚。在剖宫产术后发生产后子宫内膜炎的女性中，克林霉素与庆大霉素或氨苄西林联合的双药疗法以及第二代和第三代头孢菌素的单药疗法比传统疗法更有效。
