Schwarz R H
Clin Obstet Gynecol. 1976 Mar;19(1):97-108. doi: 10.1097/00003081-197603000-00010.
A discussion of postoperative infections in obstetrics and gynecology has been presented with particular emphasis on soft tissue infections involving the operative site. It has been emphasized that the offending organisms are those normally found in the vagina and cervix and that mixed infections are common. The immediate life threats to the patient are endotoxin shock and clostridial sepsis; therefore, initial therapy should include coverage for those organisms. Because of the potential toxicity of clindamycin and chloramphenicol, as well as the usual protracted course of Bacteroides infections, the addition of one of these drugs can generally be deferred until its use is dictated by microbiologic data or a failure of clinical response. Persistent fever generally indicates a lack of the appropriate antibiotic, an undrained collection of pus, or concomitant pelvic thrombophlebitis, the latter being a special concern with anaerobic infections. Specific infections and their management have also been discussed as have urinary tract and pulmonary infections and drug fever.
本文讨论了妇产科术后感染，特别强调了涉及手术部位的软组织感染。文中强调，致病微生物是那些通常在阴道和宫颈中发现的微生物，混合感染很常见。对患者直接的生命威胁是内毒素休克和梭菌败血症；因此，初始治疗应包括针对这些微生物的覆盖。由于克林霉素和氯霉素的潜在毒性，以及拟杆菌感染通常病程迁延，一般可以推迟添加这两种药物中的一种，直到微生物学数据表明需要使用或临床反应不佳时再用。持续发热通常表明缺乏合适的抗生素、有未引流的脓液积聚或伴有盆腔血栓性静脉炎，后者是厌氧菌感染时特别需要关注的问题。文中还讨论了特定感染及其处理方法，以及尿路感染、肺部感染和药物热。
