cefoxitin and Pelvic-Inflammatory-Disease

Topics: Anti-Bacterial Agents; Cefoxitin; Doxycycline; Female; Humans; Infertility, Female; Pelvic Inflammatory Disease

A statistical analysis of 58 reports involving 101 clinical trials and over 4,000 patients revealed that there was no statistically significant difference in the cure rates between single-agent and combination therapy. Also, there was no difference in the cure rates between antibiotic regimens that cover Chlamydia trachomatis and those that do not. However, there was a difference in cure rates when regimens with good antianaerobe activity were compared to those with poor coverage of anaerobes. There was a statistically significantly higher cure rate when "newer" regimens (mainly the second and third generations of cephalosporins and newer penicillins) were compared to "older" regimens (mainly penicillin and tetracycline). In 91 comparisons there were no statistically significant differences between regimens with a > 90% cure rate. Optimum therapy is discussed in terms of the cure rate, coverage of known pathogens and antibiotic toxicity. The original and revised recommendations of the Centers for Disease Control for the treatment of acute pelvic inflammatory disease are also reviewed.

Topics: Acute Disease; Anti-Bacterial Agents; Aztreonam; Cefotetan; Cefoxitin; Chlamydia Infections; Chlamydia trachomatis; Clindamycin; Drug Evaluation; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Gentamicins; Humans; Pelvic Inflammatory Disease; Tetracycline Resistance

As pelvic inflammatory disease (PID) aetiology is not completely understood, we examined the relationship between select novel bacteria, PID and long-term sequelae.. Fastidious bacterial vaginosis (BV)-associated bacteria (Sneathia (Leptotrichia) sanguinegens, Sneathia amnionii, Atopobium vaginae and BV-associated bacteria 1 (BVAB1)), as well as Ureaplasma urealyticum and Ureaplasma parvum were identified in cervical and endometrial specimens using organism-specific PCR assays among 545 women enrolled in the PID Evaluation and Clinical Health study. Risk ratios and 95% CIs were constructed to determine associations between bacteria, histologically confirmed endometritis, recurrent PID and infertility, adjusting for age, race, gonorrhoea and chlamydia. Infertility models were additionally adjusted for baseline infertility.. Persistent detection of BV-associated bacteria was common (range 58% for A. vaginae to 82% for BVAB1) and elevated the risk for persistent endometritis (RRadj 8.5, 95% CI 1.6 to 44.6) 30 days post-cefoxitin/doxycycline treatment, independent of gonorrhoea and chlamydia. In models adjusted for gonorrhoea and chlamydia, endometrial BV-associated bacteria were associated with recurrent PID (RRadj 4.7, 95% CI 1.7 to 12.8), and women who tested positive in the cervix and/or endometrium were more likely to develop infertility (RRadj 3.4, 95% CI 1.1 to 10.4). Associations between ureaplasmas and PID sequelae were modest.. To our knowledge, this is the first prospective study to demonstrate that S. sanguinegens, S. amnionii, BVAB1 and A. vaginae are associated with PID, failure of the Centers for Disease Control and Prevention-recommended treatment to eliminate short-term endometritis, recurrent PID and infertility. Optimal antibiotic regimens for PID may require coverage of novel BV-associated microbes.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cefoxitin; Doxycycline; Drug Therapy, Combination; Endometritis; Female; Humans; Infertility, Female; Pelvic Inflammatory Disease; Prospective Studies; United States; Vagina; Vaginosis, Bacterial; Young Adult

PEACH trial data were used to evaluate the relationship between subsequent sexually transmitted infection and recurrent pelvic inflammatory disease on infertility and chronic pelvic pain (CPP). Recurrent pelvic inflammatory disease was associated with an almost 2-fold increase in infertility and more than 4-fold increase in CPP. Subsequent sexually transmitted infection was associated with CPP, but not infertility.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cefoxitin; Chronic Pain; Doxycycline; Female; Follow-Up Studies; Humans; Infertility, Female; Pelvic Inflammatory Disease; Pelvic Pain; Pregnancy; Pregnancy Complications; Probenecid; Recurrence; Reproductive Health; Sexually Transmitted Diseases; Treatment Outcome; United States; Uricosuric Agents; Young Adult

This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.. Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.. Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.. Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.

Topics: Administration, Oral; Adolescent; Adult; Cefoxitin; Dose-Response Relationship, Drug; Doxycycline; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Infertility, Female; Inflammation Mediators; Infusions, Intravenous; Pain Measurement; Pelvic Inflammatory Disease; Predictive Value of Tests; Probability; Probenecid; Proportional Hazards Models; Recurrence; Severity of Illness Index; Time Factors; Treatment Outcome

As Mycoplasma genitalium is associated with pelvic inflammatory disease (PID), we examined the efficacy of a commonly used PID antimicrobial in treating M genitalium upper genital tract infection.. In the PID Evaluation and Clinical Health study of inpatient versus outpatient treatment, 682 women treated with cefoxitin and doxycycline for clinically suspected PID had stored cervical and endometrial specimens available for analysis. In the current sub study, we compared baseline endometritis, short term treatment failure (continued endometritis and pelvic pain 30 days following treatment) and sequelae among women with and without M genitalium, identified using PCR.. Endometrial M genitalium was associated with baseline endometritis (adjusted OR 3.0, 95% CI 1.5 to 6.1). Among women with a positive baseline M genitalium test, 41% tested positive again 30 days following treatment. Women testing positive compared to those testing negative for M genitalium at baseline had an increased risk of short-term treatment failure (RR 4.6, 95% CI 1.1 to 20.1). Rates of sequelae, including infertility (22%), recurrent PID (31%) and chronic pelvic pain (42%), were high among women testing positive for endometrial M genitalium at baseline. There was a non-significant trend towards increased infertility, chronic pelvic pain and recurrent PID, and decreased pregnancy and live birth following M genitalium infection.. M genitalium is associated with endometritis and short-term PID treatment failure. Cefoxitin and doxycycline, a Centers for Disease Control and Prevention recommended PID treatment regimen, is ineffective for the treatment of M genitalium upper genital tract infection.

Topics: Adult; Aged; Anti-Bacterial Agents; Cefoxitin; Doxycycline; Drug Therapy, Combination; Endometritis; Female; Humans; Infertility, Female; Middle Aged; Mycoplasma genitalium; Mycoplasma Infections; Pelvic Inflammatory Disease; Recurrence; Risk Factors; Treatment Failure

Among all women with pelvic inflammatory disease (PID), prevention of adverse reproductive consequences appears to be similarly achieved by outpatient treatment and inpatient treatment. We assessed whether outpatient is as effective as inpatient treatment in relevant age, race, and clinical subgroups of women with PID.. Women with clinical signs and symptoms of mild-to-moderate pelvic inflammatory disease (n = 831) were randomized into a multicenter trial of inpatient treatment, initially employing intravenous cefoxitin and doxycycline compared with outpatient treatment consisting of a single intramuscular injection of cefoxitin and oral doxycycline. Comparisons between treatment groups during a mean of 84 months of follow-up were made for pregnancies, live births, time to pregnancy, infertility, PID recurrence, chronic pelvic pain, and ectopic pregnancy.. Outpatient treatment assignment did not adversely impact the proportion of women having one or more pregnancies, live births, or ectopic pregnancies during follow-up; time to pregnancy; infertility; PID recurrence; or chronic pelvic pain among women of various races; with or without previous PID; with or without baseline Neisseria gonorrhoeae and/or Chlamydia trachomatis infection; and with or without high temperature/white blood cell count/pelvic tenderness score. This was true even in teenagers and women without a previous live birth. Ectopic pregnancies were more common in the outpatient than the inpatient treatment group, but because these were so rare, the difference did not reach statistical significance (5 versus 1, odds ratio 4.91, 95% confidence interval 0.57-42.25).. Among all women and subgroups of women with mild-to-moderate PID, there were no differences in reproductive outcomes after randomization to inpatient or outpatient treatment.. I.

Topics: Adult; Ambulatory Care; Anti-Bacterial Agents; Cefoxitin; Doxycycline; Drug Therapy, Combination; Female; Hospitalization; Humans; Infusions, Intravenous; Injections, Intramuscular; Pelvic Inflammatory Disease; Pregnancy; United States

We investigated the association between endometritis and reproductive morbidity.. Participants were 614 women in the PID Evaluation and Clinical Health (PEACH) Study with pelvic pain, pelvic organ tenderness, and leukorrhea, mucopurulent cervicitis, or untreated cervicitis. We compared women with endometritis (>or=5 neutrophils or >or=2 plasma cells), Neisseria gonorrhoeae or Chlamydia trachomatis upper genital tract infection (UGTI) or both to women without endometritis/UGTI for outcomes of pregnancy, infertility, recurrent pelvic inflammatory disease (PID), and chronic pelvic pain (CPP), adjusting for age, race, education, PID history, and baseline infertility.. Endometritis/UGTI was not associated with reduced pregnancy (odds ratio [OR] 0.8, 95% CI 0.6-1.2) or elevated infertility (OR 1.0, 95% CI 0.6-1.6), recurrent PID (OR 0.6, 95% CI 0.4-0.9), or CPP (OR 0.6, 95% CI 0.4-0.9). PEACH participants with and without endometritis/UGTI had higher age- and race-specific pregnancy rates than 1997 national rates.. Among women with clinically suspected mild-to-moderate PID treated with standard antibiotics, endometritis/UGTI was not associated with reproductive morbidity.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Bacteria, Anaerobic; Bacterial Infections; Cefoxitin; Chlamydia Infections; Doxycycline; Endometritis; Endometrium; Female; Gonorrhea; Humans; Infertility, Female; Odds Ratio; Pelvic Inflammatory Disease; Pregnancy; Probenecid; Time Factors

Pelvic inflammatory disease (PID) is a common and morbid intraperitoneal infection. Although most women with pelvic inflammatory disease are treated as outpatients, the effectiveness of this strategy remains unproven.. We enrolled 831 women with clinical signs and symptoms of mild-to-moderate pelvic inflammatory disease into a multicenter randomized clinical trial of inpatient treatment initiated by intravenous cefoxitin and doxycycline versus outpatient treatment that consisted of a single intramuscular injection of cefoxitin and oral doxycycline. Long-term outcomes were pregnancy rate, time to pregnancy, recurrence of pelvic inflammatory disease, chronic pelvic pain, and ectopic pregnancy.. Short-term clinical and microbiologic improvement were similar between women randomized to the inpatient and outpatient groups. After a mean follow-up period of 35 months, pregnancy rates were nearly equal (42.0% for outpatients and 41.7% for inpatients). There were also no statistically significant differences between outpatient and inpatient groups in the outcome of time to pregnancy or in the proportion of women with pelvic inflammatory disease recurrence, chronic pelvic pain, or ectopic pregnancy.. Among women with mild-to-moderate pelvic inflammatory disease, there was no difference in reproductive outcomes between women randomized to inpatient treatment and those randomized to outpatient treatment.

Topics: Adolescent; Adult; Ambulatory Care; Anti-Bacterial Agents; Cefoxitin; Cephamycins; Doxycycline; Female; Follow-Up Studies; Hospitalization; Humans; Injections, Intramuscular; Injections, Intravenous; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Rate; Severity of Illness Index

Trovafloxacin, a broad-spectrum fourth-generation quinolone with gram-positive and gram-negative aerobic and anaerobic bacterial activity, is available in oral and intravenous formulations. The objective of this prospective, multicenter, double-blind, randomized study was to compare the efficacy of trovafloxacin with that of cefoxitin, an approved drug for treatment of acute gynecologic infections, together with amoxicillin/clavulanic acid as oral follow-on treatment.. Patients with a clinical diagnosis of acute pelvic infection received either intravenous alatrofloxacin with oral trovafloxacin follow-on (trovafloxacin) or a combined regimen of cefoxitin followed by amoxicillin/clavulanic acid for a maximum of 14 days. The primary endpoint was clinical response to therapy on follow-up at day 30.. Clinical success rates were comparable between the trovafloxacin (n = 107) and comparative (n = 119) groups at study end (90% vs. 86%, respectively; 95% confidence interval, -4.5, 12.5). Among clinically evaluable patients, clinical success rates for infections involving Enterococcus species were higher with trovafloxacin than with the comparative regimen at the end of treatment (96% and 85%) and at study end (96% and 86%).. Intravenous alatrofloxacin followed by oral trovafloxacin for a maximum of 14 days of total therapy was efficacious in the treatment of acute pelvic infections.

Topics: Acute Disease; Adolescent; Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents; Cefoxitin; Cephamycins; Clavulanic Acid; Double-Blind Method; Enterococcus; Female; Fluoroquinolones; Humans; Middle Aged; Naphthyridines; Pelvic Inflammatory Disease; Penicillins; Prospective Studies; Treatment Outcome

The aim of this presentation is to study the advantages and disadvantages of perioperative prophylaxis with the antibiotic Mefoxin against the classical postoperative antibiotic prophylaxis with penicillin and gentamicine, as well as to analyse the place of this antibiotic in modern treatment of different forms of pelvic inflammatory disease. The authors conclude that the qualities of Mefoxin (high resistant wide spectrum antibiotic, covering aerobes and anaerobes), make it an ideal antibiotic for perioperative prophylaxis in gynaecologic and oncologic surgery; the clinical effectiveness of Mefoxin in the treatment of inflammatory diseases of the female pelvis precludes the need for a combined parenteral antibiotic therapy.

Topics: Ampicillin; Analysis of Variance; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefoxitin; Cephamycins; Combined Modality Therapy; Female; Gentamicins; Humans; Pelvic Inflammatory Disease; Penicillins

This six-center, prospective, open-label clinical trial compared the efficacy and safety of three regimens recommended by the Centers for Disease Control and Prevention (CDC) for the treatment of women hospitalized for acute pelvic inflammatory disease (PID). The study focused on the response to inpatient therapy, not on long-term prevention of sequelae. A severity score was used for objective comparison of the degree of illness before and after therapy. Women were randomly assigned (in a 1:1:1 ratio) to treatment with cefoxitin plus doxycycline, clindamycin plus gentamicin, or cefotetan plus doxycycline. Two hundred seventy-five (94.2%) of 292 evaluable women required no alteration in therapeutic regimen. The three regimens produced almost identical cure rates. No serious adverse clinical or laboratory events were observed. In short, the three regimens recommended by the CDC for inpatient therapy of acute PID were similarly effective and safe.

Topics: Acute Disease; Adolescent; Adult; Cefotetan; Cefoxitin; Centers for Disease Control and Prevention, U.S.; Clindamycin; Doxycycline; Drug Therapy, Combination; Female; Gentamicins; Hospitalization; Humans; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Prospective Studies; Severity of Illness Index; United States

The efficacy and safety of two antibiotic regimens for the treatment of acute pelvic inflammatory disease (PID) was compared in a prospective and randomised study. 57 patients received either 0.2 gms ciprofloxacin intravenously b.i.d. in combination with 0.5 g metronidazole intravenously t.i.d. (n = 26), or alternatively 2 g cefoxitin intravenously t.i.d. in combination with doxycycline 0.1 g b.i.d. (n = 31). After commencing therapy intravenously, medication with ciprofloxacin, metronidazole and doxycycline was continued orally after two or three days. In the ciprofloxacin/metronidazole group, PID was found to be severe in 7, moderate in 12 and mild in 7 patients. The numbers in the cefoxitin/doxycycline group were 8, 20 and 3 respectively. The clinical result after treatment with ciprofloxacin/metronidazole was resolution of all symptoms in 24 patients and improvement in 2 others. In the cefoxitin/doxycycline treated group, resolution was found in 27 patients, improvement in 2 others. Failure occurred in 2 patients. 53 different microorganisms as the suspected cause of PID were isolated in the ciprofloxacin/metronidazole group and 56 in the cefoxitin/doxycycline group. According to our clinical and bacteriological criteria, treatment for PID was successful in 97% of the ciprofloxacin/metronidazole group and in 87% of the cefoxitin/doxycycline group. Adverse reactions were found in 4 patients in the ciprofloxacin/metronidazole treated group. Therapy had to be terminated in 3 of these patients. In the cefoxitin/doxycycline group 2 patients had adverse reactions, and therapy had to be terminated in one of these patients. According to our results, both antibiotic regimens can be recommended for the treatment of PID.

Topics: Adult; Bacterial Infections; Bacteriological Techniques; Cefoxitin; Ciprofloxacin; Dose-Response Relationship, Drug; Doxycycline; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Metronidazole; Pelvic Inflammatory Disease; Prospective Studies

To evaluate the efficacy and safety of ampicillin-sulbactam (3 g every 6 hours) in patients with pelvic inflammatory disease or postpartum endometritis using a randomized, comparative, multicenter study of parallel design.. Eligible patients with pelvic inflammatory disease were randomized to receive either ampicillin-sulbactam or cefoxitin (2 g every 6 hours) plus doxycycline (100 mg every 12 hours). Those with endometritis were randomized to ampicillin-sulbactam or clindamycin (900 mg every 8 hours) plus gentamicin (1.5 mg/kg every 8 hours). In the ampicillin-sulbactam group, chlamydia-positive patients also received oral doxycycline.. For pelvic inflammatory disease, the clinical response rates (cure or improvement) were 85.5% (47 of 55) and 89.6% (43 of 48) in the ampicillin-sulbactam and cefoxitin and doxycycline groups, respectively (chi 2 = 0.10, P = .76). For endometritis, the clinical response rates were 88.7% (141 of 159) and 90.8% (139 of 153) in the ampicillin-sulbactam and clindamycin and gentamicin groups, respectively (chi 2 = 0.15, P = .70). The percentages of patients with pelvic inflammatory disease who had adverse experiences were not significantly different in the cefoxitin and doxycycline group (47% [29 of 62]) than in those receiving ampicillin-sulbactam (33% [22 of 66]) (P = .12). These adverse effects were mostly mild or moderate. In the endometritis subjects, the incidence of adverse experiences in the ampicillin-sulbactam group (11% [20 of 179]) was comparable to that during treatment with clindamycin and gentamicin (12% [22 of 180]). These adverse experiences were also mostly mild to moderate.. Ampicillin-sulbactam is as effective and well tolerated as combination regimens using cefoxitin plus doxycycline and clindamycin plus-gentamicin for the treatment of pelvic inflammatory disease or endometritis, respectively.

Topics: Adult; Ampicillin; Cefoxitin; Clindamycin; Doxycycline; Drug Therapy, Combination; Endometritis; Female; Gentamicins; Humans; Pelvic Inflammatory Disease; Puerperal Infection; Sulbactam

A multicenter randomized comparative trial was done to assess the safety and efficacy of oral ofloxacin (400 mg twice daily for 10 days) versus cefoxitin (2 g intramuscularly) followed by doxycycline (100 mg twice daily orally for 10 days) for the outpatient treatment of uncomplicated pelvic inflammatory disease (PID). Neisseria gonorrhoeae (GC) grew on pretreatment endocervical cultures from 43 of 268 women (16%), and in 30 of 247 women (12%) cultures were positive for Chlamydia trachomatis (Ct). Ninety-five percent (122/128) of the women treated with the ofloxacin regimen and 93% (112/121) of those treated with the cefoxitin/doxycycline regimen had cure or improvement on examination at a minimum of one follow-up visit. All GC species were eradicated by both ofloxacin and cefoxitin. Among women who returned for follow-up, the eradication of C trachomatis was 88% (15/17) for the cefoxitin/doxycycline group and 100% (18/18) for ofloxacin. Side effects were more prevalent in the cefoxitin/doxycycline group (15%) than in the ofloxacin group (7%), nausea/vomiting being the most frequent adverse effect. In this study, it appears that ofloxacin and cefoxitin/doxycycline have similar clinical effectiveness for the outpatient treatment of uncomplicated pelvic inflammatory disease.

Topics: Adolescent; Adult; Ambulatory Care; Cefoxitin; Chlamydia Infections; Chlamydia trachomatis; Doxycycline; Drug Therapy, Combination; Female; Gonorrhea; Humans; Middle Aged; Ofloxacin; Pelvic Inflammatory Disease; Probenecid; Treatment Outcome

The clinical efficacy and safety of clindamycin-gentamicin versus doxycycline-cefoxitin in the treatment of acute pelvic inflammatory disease was evaluated in a comparative, randomized, prospective, multicenter study. Ten investigators enrolled 170 patients. Those judged to be eligible for efficacy were 60/88 (68%) who received the clindamycin-gentamicin regimen and 55/82 (67%) of those treated with cefoxitin-doxycycline. A successful clinical outcome was attained for 52/60 (87%) and 46/55 (84%) for patients treated with clindamycin-gentamicin and cefoxitin-doxycycline, respectively, a difference that was not statistically significant. In the clindamycin-gentamicin series, 8/8 (100%) of patients with positive C. trachomatis culture at baseline were culture negative at the late follow-up 21-35 days after treatment. For those given cefoxitin-doxycycline, 9/11 (82%) who had C. trachomatis at pretreatment showed eradication at follow-up. Neisseria gonorrhoeae was present at baseline in 8/60 (13%) of the clindamycin-gentamicin patients and in 9/55 (16%) of those treated with cefoxitin-doxycycline. Of those who had appropriate follow-up cultures performed, 6 in the clindamycin-gentamicin group and 8 in the cefoxitin-doxycycline series, all showed eradication of the organism. It is concluded that clindamycin-gentamicin and cefoxitin-doxycycline have similar clinical cure rates for acute pelvic inflammatory disease, and based on this limited experience, it is suggested that the clindamycin-gentamicin combination will satisfactorily eradicate Chlamydia trachomatis and Neisseria gonorrhoeae when either or both of these pathogens are present.

Topics: Acute Disease; Adolescent; Adult; Cefoxitin; Clindamycin; Doxycycline; Drug Therapy, Combination; Female; Gentamicins; Humans; Middle Aged; Pelvic Inflammatory Disease; Prospective Studies

Ampicillin-sulbactam (750 mg) given orally twice daily for 10 days was evaluated for the treatment of acute pelvic inflammatory disease (PID) in an ambulatory setting in Nairobi, Kenya. The first 26 women received ampicillin-sulbactam in an open-label fashion, and the remaining 75 women were randomly selected to receive either ampicillin-sulbactam (n = 38) or cefoxitin (2 g) intramuscularly and probenecid (1 g) orally, followed by doxycycline (100 mg) orally twice daily for 10 days (n = 37). Women were enrolled in a sexually transmitted disease clinic and were followed for clinical and microbiologic responses at 1 to 2 weeks and 4 to 6 weeks posttreatment. Women had a later follow-up visit to note interim pregnancy or underwent hysterosalpingography for fertility outcome assessment. The short-term clinical response rates were 70% for ampicillin-sulbactam and 72% for cefoxitin-doxycycline (P = 0.47). Among Chlamydia trachomatis-infected women treated with ampicillin-sulbactam, three had microbiologic relapse. The post-PID tubal obstruction rates were similar in the two groups: 18% for ampicillin-sulbactam and 33% for cefoxitin-doxycycline (P = 0.31). Neither regimen was highly effective as a therapy for acute PID. These data strongly argue that primary prevention must be the goal for a reduction of PID morbidity and show that improved therapy for the treatment of PID in the ambulatory setting is needed.

Topics: Acute Disease; Adult; Ambulatory Care; Ampicillin; Cefoxitin; Doxycycline; Drug Therapy, Combination; Fallopian Tubes; Female; Fertility; Follow-Up Studies; Humans; Hysterosalpingography; Pelvic Inflammatory Disease; Sulbactam

In this prospective trial, 130 hospitalized patients with acute pelvic inflammatory disease based on clinical criteria were randomly treated with intravenous gentamicin plus clindamycin (N = 63) or cefoxitin plus doxycycline (N = 67) for at least 4 days, followed by oral clindamycin or doxycycline, respectively, for a total of 14 days. Pre-treatment cultures were obtained for endocervical Neisseria gonorrhoeae and Chlamydia trachomatis, and for endometrial C trachomatis and aerobic and anaerobic bacteria. Overall, 46 subjects (35%) had endocervical cultures positive for N gonorrhoeae. Endocervical and endometrial cultures were positive for C trachomatis in 16 and 6%, respectively. Ninety-five percent of patients had at least one aerobic bacterium, 38% had at least one anaerobic bacterium, and only 2% had no organisms isolated from their endometrium. Fifty-seven subjects taking gentamicin-clindamycin (90.5%) and 64 subjects taking cefoxitin-doxycycline (95.5%) were clinically cured, a nonsignificant difference. Three subjects treated with gentamicin-clindamycin and one treated with cefoxitin-doxycycline required hysterectomy or salpingectomy for cure. Follow-up examinations and cultures were performed in 84% of the subjects. Post-treatment cultures for N gonorrhoeae were negative in all cases tested. Post-treatment endocervical and endometrial C trachomatis cultures were negative in ten of 11 subjects treated with gentamicin-clindamycin and in eight of nine treated with cefoxitin-doxycycline, a nonsignificant difference. We conclude that gentamicin-clindamycin and cefoxitin-doxycycline have similar clinical cure rates for acute pelvic inflammatory disease and are equivalent in eradicating genital N gonorrhoeae and C trachomatis.

Topics: Acute Disease; Adult; Bacteria; Cefoxitin; Cervix Uteri; Clindamycin; Doxycycline; Drug Therapy, Combination; Endometrium; Female; Gentamicins; Humans; Pelvic Inflammatory Disease; Prospective Studies; Randomized Controlled Trials as Topic

Patients with uncomplicated pelvic inflammatory disease (PID) (acute salpingitis and no pelvic masses) were randomly assigned for treatment with either cefotaxime or cefoxitin. A clinical cure was achieved in 17 of 20 cases (82%) and 19 of 22 cases (84%), respectively. Within the complicated PID group, patients were assigned to two subgroups: those with a tubo-ovarian complex (26 patients), and those with a tubo-ovarian abscess (32 patients), as confirmed by ultrasonography or surgery. Patients within each of these two subgroups were then randomly assigned for treatment with either cefotaxime or clindamycin plus gentamicin. Within the tubo-ovarian complex subgroup, a clinical cure was achieved in 11 of 13 cases (85%) treated with cefotaxime and 10 of 13 cases (77%) treated with clindamycin plus gentamicin. Within the tubo-ovarian abscess subgroup, a clinical cure was achieved in 12 of 16 cases (75%) treated with cefotaxime and 11 of 16 cases (69%) treated with clindamycin plus gentamicin. No differences in any category were statistically significant. Specimens for culture were obtained from the endocervix, endometrium, and when possible, the cul-de-sac, fallopian tubes, and abscess. Neisseria gonorrhoeae (33%) was isolated more frequently than Chlamydia trachomatis (12%) in patients with PID, and neither of these organisms was isolated with any increased frequency in patients with complicated PID. The majority of the patients were considered to have polymicrobial infection. Cefotaxime was as efficacious as cefoxitin and clindamycin plus gentamicin for the treatment of acute salpingitis, tubo-ovarian complex and tubo-ovarian abscess.

Topics: Adolescent; Adult; Bacteria; Bacteroides; Cefotaxime; Cefoxitin; Chlamydia trachomatis; Clindamycin; Drug Therapy, Combination; Female; Genitalia, Female; Gentamicins; Humans; Middle Aged; Pelvic Inflammatory Disease

The identification of pathogens and the early recognition of pelvic infections in patients after hysterectomy, cesarean delivery and vaginal delivery were analyzed. Criteria for administering cephamycin therapy were established, as were guidelines for evaluating the progress of the infection. In a comparative study of the safety and efficacy of cefmetazole and cefoxitin in 145 hospitalized patients with pelvic infections there were no significant differences between either the bacteriologic or clinical cure rates of the two antibiotics. Both were efficacious and safe for the treatment of obstetric-gynecologic soft tissue infections.

Topics: Bacterial Infections; Cefmetazole; Cefoxitin; Cesarean Section; Delivery, Obstetric; Female; Humans; Hysterectomy; Pelvic Inflammatory Disease; Pregnancy; Prospective Studies

A total of 54 women with acute salpingitis were treated intravenously with ampicillin/sulbactam or cefoxitin in a prospective, randomized, ongoing study. Of the organisms isolated, Gram-negative species (excluding Neisseria gonorrhoeae) were considerably more likely to produce beta-lactamase than were Gram-positive species. Clinical efficacy was 94% for 2 g ampicillin plus 1 g sulbactam and 89% for 2 g cefoxitin, all given intravenously every 6 h. The addition of sulbactam, an irreversible beta-lactamase inhibitor, to ampicillin restored both the microbiological and clinical activities of ampicillin. Both regimens were equally safe and demonstrated good efficacy in the treatment of the acute, symptomatic phase of infection.

Topics: Acute Disease; Adult; Ampicillin; beta-Lactamase Inhibitors; beta-Lactamases; Cefoxitin; Drug Therapy, Combination; Female; Humans; Injections, Intravenous; Pelvic Inflammatory Disease; Prospective Studies; Remission Induction; Sulbactam

Sixty-two women were randomized in a double-blind fashion to receive one of two antibiotic regimens for the treatment of clinically diagnosed pelvic inflammatory disease. Thirty of 31 patients (96.8%) receiving a combination of cefoxitin with doxycycline and 28 of 31 (90.3%) receiving a combination of clindamycin with amikacin responded to therapy (P = not significant). Chlamydia trachomatis, Neisseria gonorrhoeae, or both were isolated from 13.3, 7.0, and 4.8% of patients, respectively. Of the four patients not responding to therapy, all had inflammatory complexes. Cefoxitin/doxycycline and clindamycin/amikacin are both effective in the treatment of pelvic inflammatory disease.

Topics: Acute Disease; Amikacin; Anti-Bacterial Agents; Cefoxitin; Cervix Uteri; Chlamydia trachomatis; Clindamycin; Clinical Trials as Topic; Double-Blind Method; Doxycycline; Drug Therapy, Combination; Female; Humans; Neisseria gonorrhoeae; Pelvic Inflammatory Disease; Prospective Studies; Random Allocation

Acute pelvic inflammatory disease remains the major medical and economic consequence of sexually transmitted diseases among young women. The polymicrobial origins of pelvic inflammatory disease have been well documented and the major organisms recovered from the upper genital tract in patients with pelvic inflammatory disease include Chlamydia trachomatis, Neisseria gonorrhoeae, and mixed anaerobic and aerobic bacteria. This study was undertaken to compare the efficacy and safety of cefotetan plus doxycycline with that of cefoxitin plus doxycycline in the treatment of hospitalized patients with acute pelvic inflammatory disease. A total of 68 hospitalized patients with acute pelvic inflammatory disease were entered and randomized into two treatment groups: cefotetan (n = 32) and cefoxitin (n = 36). There were six tuboovarian abscesses in each group. C. trachomatis was recovered from 7 (10%) and N. gonorrhoeae from 48 (71%) of the patients. Anaerobic and aerobic bacteria were recovered from the upper genital tract in 53 (78%) of the patients. Cefotetan plus doxycycline and cefoxitin plus doxycycline demonstrated high rates of initial clinical response in the treatment of acute pelvic inflammatory disease. Clinical cure was noted in 30 (94%) of the cefotetan plus doxycycline group and 33 (92%) of the cefoxitin plus doxycycline group. Four failures were sonographically diagnosed tuboovarian abscesses that responded to clindamycin plus gentamicin therapy. The fifth failure was an uncomplicated case that did not respond to cefoxitin and doxycycline and required additional therapy. At 1 week and 3 weeks, respectively, the posttreatment cultures demonstrated eradication, in all instances, of N. gonorrhoeae and C. trachomatis. These regimens also were very effective in eradicating anaerobic and aerobic pathogens from the endometrial cavity. Both regimens were well tolerated by the patients, and few adverse drug affects were noted.

Topics: Acute Disease; Adolescent; Adult; Cefotetan; Cefoxitin; Cephamycins; Chlamydia Infections; Doxycycline; Drug Therapy, Combination; Female; Gonorrhea; Hospitalization; Humans; Pelvic Inflammatory Disease

In this study, 17 women were treated for uncomplicated acute pelvic inflammatory disease requiring hospitalisation for therapy, and 5 women were treated for the same infection complicated by pelvic abscesses. Treatment regimens were sulbactam 1g plus ampicillin 2g (14 women) or cefoxitin 2g (8 women) given by intravenous infusion every 6 hours. On the third day of therapy, a rash developed in 1 woman who was being successfully treated for uncomplicated disease with sulbactam/ampicillin. The other 21 women were cured. No other adverse clinical reactions and no significant abnormal laboratory results were observed with either regimen. Bacteriological efficacy, 98% for sulbactam/ampicillin and 94% for cefoxitin, closely paralleled clinical efficacy. Sulbactam, a suicide-type beta-lactamase inhibitor, appears to have restored and expanded the antibacterial activity of ampicillin.

Topics: Acute Disease; Adolescent; Adult; Ampicillin; Bacteria, Anaerobic; Cefoxitin; Drug Combinations; Female; Humans; Pelvic Inflammatory Disease; Sulbactam

Two hundred eighty-seven women were treated in a multicenter, randomized, comparative study to compare the safety and efficacy of cefotetan every 12 hours with that of cefoxitin every 6 or 8 hours in the treatment of acute obstetric and gynecologic pelvic infections. The most frequent primary diagnoses in both groups were endometritis and pelvic inflammatory disease; 24 of these patients were also bacteremic. The mean duration of treatment was 5.2 and 5.4 days for the cefotetan and cefoxitin groups, respectively, and the total doses administered were 18.1 and 32.1 gm, respectively. The rate of clinical failure for the cefotetan group was 8.5% and 12.2% for the cefoxitin group. Laboratory and clinical adverse reactions were infrequent and none was serious; both antimicrobials were well tolerated. These results suggest the administration of cefotetan provided adequate clinical and bacteriologic effectiveness in the treatment of hospital- and community-acquired, polymicrobial obstetric and gynecologic pelvic infections.

Topics: Acute Disease; Adult; Bacterial Infections; Cefotetan; Cefoxitin; Cephamycins; Clinical Trials as Topic; Cross Infection; Endometritis; Female; Genital Diseases, Female; Humans; Pelvic Inflammatory Disease; Random Allocation

Because of the high incidence of beta-lactamase production among bacteria that are found commonly in pelvic infections in women, beta-lactamase-inhibiting antibiotics should prove effective in treating those infections. In a randomized, comparative study of 47 women with intraabdominal infections, 23 received ticarcillin disodium/clavulanate potassium, and 24 received cefoxitin. Among the infections treated were endometritis, pelvic inflammatory disease, amnionitis, salpingitis, septicemia, intraabdominal abscess and pelvic abscess. The bacteriologic response to ticarcillin disodium/clavulanate potassium was 88.8% success as compared with 87.5% for cefoxitin. Clinical cures were achieved in 98.8% of patients treated with ticarcillin disodium/clavulanate potassium and 90.9% of patients treated with cefoxitin. The adverse reactions were diarrhea, transient eosinophilia and transient thrombocytosis.

Topics: Adult; Bacterial Infections; beta-Lactamase Inhibitors; Cefoxitin; Clavulanic Acid; Clavulanic Acids; Clinical Trials as Topic; Drug Combinations; Endometritis; Female; Humans; Pelvic Inflammatory Disease; Penicillins; Random Allocation; Ticarcillin

Cefotetan is a recently introduced cephamycin antibiotic for parenteral administration, with a broad spectrum of antibacterial activity. Its elimination half-life of three hours or more allows a twice-daily dosage schedule. A noncomparative trial of cefotetan yielded a satisfactory clinical response in the treatment of all of ten patients with pelvic infection. Subsequently, we did a prospective, randomized comparative study of 53 patients with pelvic infections treated with either cefotetan (2 gm IV every 12 hours) or cefoxitin (2 gm IV every six to eight hours). Both drugs showed similar clinical efficacy and antimicrobial activity (100% [n = 36] with cefotetan and 94% [n = 17] with cefoxitin, the difference not statistically significant). A mean of 21.3 gm of cefotetan was required, as compared with 34.4 gm of cefoxitin, a statistically significant difference (P less than .001). Use of cefotetan is therefore more cost effective.

Topics: Adult; Bacteria; Bacterial Infections; Cefotetan; Cefoxitin; Cephamycins; Chorioamnionitis; Endometritis; Female; Genital Diseases, Female; Humans; Microbial Sensitivity Tests; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Complications, Infectious; Prospective Studies; Random Allocation

Cefoxitin and clindamycin-gentamicin were compared in a randomized study of antibiotic therapy for infections of the pelvis in 91 women. Clinical diagnoses included pelvic inflammatory disease (53), endomyometritis after cesarean section (24), and cellulitis following gynecological surgery (14). Treatment failures occurred in four (10%) of the 41 patients treated with cefoxitin compared with eight (16%) of the 50 patients treated with the clindamycin-gentamicin combination. Single-drug therapy with cefoxitin was shown to be as effective as the combination of clindamycin and gentamicin.

Topics: Adolescent; Adult; Cefoxitin; Cellulitis; Clindamycin; Drug Therapy, Combination; Endometritis; Female; Gentamicins; Humans; Middle Aged; Pelvic Inflammatory Disease; Random Allocation

Ninety-three female patients with post-cesarean endometritis, post-hysterectomy pelvic cellulitis, and other miscellaneous moderately severe pelvic soft-tissue infections were treated in a randomized fashion with either ticarcillin plus clavulanic acid or cefoxitin. Of the 47 patients treated with ticarcillin plus clavulanic acid, 38 had clinical cures, four showed improvement, therapy failed in three, and two were nonevaluable, for a failure rate of 6.7 percent. Of the 46 patients treated with cefoxitin, 33 had clinical cures, five showed improvement, therapy failed in seven, and one was nonevaluable, for a failure rate of 15.6 percent. Bacteriologically, the addition of clavulanic acid to ticarcillin was found to broaden the antibacterial spectrum to include some Escherichia coli, most Klebsiella, many coagulase-negative staphylococci, and all isolates of Staphylococcus aureus. Adverse reactions were few, with only one patient having therapy with cefoxitin discontinued because of side effects. It is concluded that ticarcillin plus clavulanic acid is quite suitable for antibiotic therapy of female pelvic soft-tissue infection, based on the (expanded) coverage of both aerobic and anaerobic bacterial species.

Topics: Adolescent; Adult; Bacterial Infections; Cefoxitin; Cellulitis; Clavulanic Acid; Clavulanic Acids; Drug Combinations; Endometritis; Female; Humans; Middle Aged; Pelvic Inflammatory Disease; Penicillins; Ticarcillin

Sixty patients with acute uncomplicated pelvic infection were treated with cefoxitin or ampicillin alone, the purpose being to show that a relatively cheap antimicrobial agent (ampicillin) could be used. The groups (30 patients in each) were clinically comparable (P greater than 0,01--Hotelling T-square test). In the first group 2 g ampicillin was administered intravenously on admission followed by 1 g intravenously 4-hourly, and in the second group 2 g cefoxitin was administered intravenously on admission followed by 1 g intravenously every 8 hours. A good response was obtained in both groups. On the basis of cost ampicillin would seem to be the treatment of choice in uncomplicated acute pelvic infection.

Topics: Acute Disease; Adolescent; Adult; Ampicillin; Cefoxitin; Clinical Trials as Topic; Female; Humans; Pelvic Inflammatory Disease; Random Allocation

A retrospective chart analysis of women undergoing elective abdominal hysterectomy in Parkland Memorial Hospital indicated significant postoperative antibiotic administration. For that reason, we conducted a prospective, double-blind, placebo-controlled study to determine the incidence of infection and febrile morbidity in this patient population and to evaluate the efficacy of perioperative cefoxitin in modifying the incidence of these conditions. Three 2 gm intramuscular doses of cefoxitin over 12 hours significantly reduced the incidence of major infection to 12% from 32% observed in the placebo group. The mean hospital stay for women given cefoxitin (5.6 days) was also significantly reduced when compared to that for women given placebo (6.4 days). The incidence of febrile morbidity not requiring therapy was significant and was not altered by perioperative cefoxitin. Febrile morbidity was observed in 42% of women given cefoxitin and in 34% of women given placebo. Administration of perioperative antimicrobial agents is necessary for women undergoing elective abdominal hysterectomy in our hospital, but we believe that individual determination is required.

Topics: Adolescent; Bacterial Infections; Cefoxitin; Cellulitis; Clinical Trials as Topic; Double-Blind Method; Female; Fever; Humans; Hysterectomy; Length of Stay; Pelvic Inflammatory Disease; Postoperative Complications; Premedication; Prospective Studies; Random Allocation

Topics: Adult; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Female; Humans; Mezlocillin; Pelvic Inflammatory Disease; Penicillins; Pneumonia; Skin Diseases, Infectious; Urinary Tract Infections

Topics: Abdomen, Acute; Anti-Bacterial Agents; Cefoxitin; Doxycycline; Exudates and Transudates; Female; Hepatitis; Humans; Laparoscopy; Metronidazole; Oophoritis; Pelvic Inflammatory Disease; Peritonitis; Salpingitis; Young Adult

Topics: Ambulatory Care; Cefoxitin; Cost Savings; Doxycycline; Female; Hospitalization; Humans; Infertility; Inpatients; Outpatients; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Probenecid; Quality of Health Care; Randomized Controlled Trials as Topic; United States

Topics: Anti-Bacterial Agents; Cefoxitin; Ceftriaxone; Ciprofloxacin; Clindamycin; Contact Tracing; Female; Genital Diseases, Male; Humans; Male; Ofloxacin; Pelvic Inflammatory Disease; Peritonitis; Pregnancy; Pregnancy Complications, Infectious; Sexually Transmitted Diseases

Topics: Ampicillin; Bacteria; Cefoxitin; Drug Evaluation; Drug Therapy, Combination; Drug Tolerance; Female; Humans; Laparoscopy; Microbial Sensitivity Tests; Pelvic Inflammatory Disease; Sulbactam; Uterus

Acute pelvic inflammatory disease is associated with significant adverse reproductive sequelae. To prevent these serious sequelae, treatment regimens must cover the major etiologic agents which are Neisseria gonorrhoeae, Chlamydia trachomatis, and mixed anaerobic-aerobic bacteria. This report concerns the prospective evaluation of the efficacy of the combination of sulbactam with ampicillin in patients hospitalized with acute pelvic inflammatory disease. Clinical cure was noted in 33 (94%) of 35 patients and post-treatment cultures demonstrated eradication of N. gonorrhoeae and C. trachomatis in all cases.

Topics: Adult; Ampicillin; Bacteria, Aerobic; Bacteria, Anaerobic; Cefoxitin; Doxycycline; Drug Therapy, Combination; Female; Gentamicins; Humans; Metronidazole; Microbial Sensitivity Tests; Pelvic Inflammatory Disease; Prospective Studies; Sulbactam

The effects of cefotetan, cefoxitin, cefazolin, and cefotaxime on polymorphonuclear leukocyte chemotaxis and chemiluminescence were determined in 10 patients with pelvic inflammatory disease and 10 oncologically treated patients. It was found that cefotetan enhanced both chemotaxis and chemiluminescence, with the favorable effects more pronounced in the oncologically treated patients with leukopenia. Cefotaxime depressed polymorphonuclear leukocyte functions. Cefoxitin and cefazolin had no significant effects. It would be logical, when treating empirically, to choose a regimen that enhances and not depresses host defenses in all patients but more expressly in leukopenic and other immunologically compromised patients.

Topics: Cefazolin; Cefotaxime; Cefotetan; Cefoxitin; Cephalosporins; Cephamycins; Chemotaxis, Leukocyte; Female; Humans; Leukopenia; Neutrophils; Pelvic Inflammatory Disease

Sixty-three women with abdominal pain and adnexal tenderness were enrolled in a study of ambulatory treatment of acute pelvic inflammatory disease. Treatment consisted of 2 g of cefoxitin intramuscularly and 1 g of probenecid orally, followed by doxycycline, 100 mg by mouth twice daily for 14 days. Patients were stratified into groups indicating whether pelvic inflammatory disease was probable, possible, or unlikely, based upon endometrial biopsy and clinical criteria. Among 52 women who were evaluated, Chlamydia trachomatis and/or Neisseria gonorrhoeae were initially recovered from 16 (67%) of 24 with probable pelvic inflammatory disease, three (33%) of 11 with possible pelvic inflammatory disease, and three (18%) of 17 in whom pelvic inflammatory disease was considered unlikely. Of the 24 patients with probable pelvic inflammatory disease, 22 (92%) were clinically cured or improved. Of 22 patients initially infected with C trachomatis and/or N gonorrhoeae, 20 were culture-negative for both organisms after therapy. Both microbiologic failures had been reexposed. This study suggests that the combination of cefoxitin and doxycycline is effective for ambulatory treatment of pelvic inflammatory disease.

Topics: Adult; Ambulatory Care; Biopsy; Cefoxitin; Chlamydia Infections; Doxycycline; Endometritis; Female; Follow-Up Studies; Gastrointestinal Diseases; Gonorrhea; Humans; Pelvic Inflammatory Disease; Salpingitis

In order to evaluate the efficacy of cefoxitin, 25 patients with serious pelvic infections admitted to a community hospital were treated with the drug. Twenty-one patients (84%) responded to this therapy. Three of the four failures (75%) had a pelvic abscess. Resistant organisms included Staphylococcus aureus, Pseudomonas aeruginosa and enterococci. The adverse reactions encountered were due to localized phlebitis, which occurred in three patients (12%). The study demonstrated that cefoxitin was successful as a single agent in the treatment of serious soft-tissue pelvic infections.

Topics: Adult; Bacterial Infections; Cefoxitin; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infusions, Intravenous; Length of Stay; Microbial Sensitivity Tests; Middle Aged; Pelvic Inflammatory Disease; Thrombophlebitis; Treatment Failure

Cefoxitin is a useful new chephamycin antibiotic available for IM of IV administration. It is a bactericidal beta-lactam antibiotic indicated for treatment of serious infections caused by a wide spectrum of gram-negative aerobic and anaerobic bacteria. Specific indications include: 1) polymicrobial infections (aerobic gram-negative rods and anaerobic bacteria); 2) nosocomial cephalothin-resistant gram-negative bacillary infections; 3) penicillin-resistant staphylococcal infections, and 4) anaerobic infections (pelvic, intraabdominal). Cefoxitin can be used as a single drug alternate to a two-drug antibiotic regimen (such as a cephalosporin-aminoglycoside combination) in polymicrobic infections of the pelvis, abdomen, skin, bones, or muscles. Cefoxitin is a significant drug in the armamentarium against anaerobic bacteria, particularly Bacteroides species. Since cefoxitin is highly resistant to staphylococcal beta-lactamase, it is effective against penicillin-resistant staphylococci. Cefoxitin has been effective in treating serious nosocomial infections caused by resistant aerobic gram-negative rods and anaerobic bacteria.

Topics: Bacteria; Bacterial Infections; Cefoxitin; Female; Humans; Infant; Infant, Newborn; Pelvic Inflammatory Disease; Surgical Wound Infection; Urinary Tract Infections

Cefoxitin was given to the 7 patients of infections in the field of obstetrics and gynecology, and the following results were obtained: 1) The clinical response was excellent in 2 patients, good in 4 and poor in 1 patient with the efficacy rate of 85.7%. Out of the 4 patients resistant to the previous therapy with other antibiotics, 3 patients responded to cefoxitin, and all the 3 patients of anaerobic infections responded satisfactorily to cefoxitin. 2) Microorganisms isolated were 2 strains each of E. coli and Staphylococcus aureus, 3 strains of Peptococcus and 1 strain of Eubacterium lentum. All the 8 strains isolated were sensitive to cefoxitin. As to bacteriological response, all the strains isolated were eradicated except 1 strain of Staphylococcus aureus which recurred on the 9th day after completion of the therapy with the eradication rate of 87.5%. 3) No subjective nor objective side effects were noted. Especially, the elevated GOT and GPT observed on a patient complicated with hepatitis prior to the initiation of cefoxitin treatment were found to be normal upon completion of the treatment.

Topics: Abdominal Muscles; Adult; Aged; Cefoxitin; Cesarean Section; Female; Fistula; Genital Diseases, Female; Humans; Middle Aged; Parametritis; Pelvic Inflammatory Disease; Postoperative Complications; Pregnancy; Pyelitis; Wound Infection