Postpartum endometritis: efficacy and tolerability of two antibiotic regimens

A prospective, multicenter, open-label randomized trial was conducted to compare the efficacy and tolerability of imipenem-cilastatin (I-C) monotherapy with clindamycin+aminoglycoside (C+A) combination therapy. Forty-nine patients were able to be evaluated for clinical efficacy in the treatment of postpartum endometritis. Twenty-three patients received I-C and 26 received C+A therapy. The two groups were statistically similar for demographic and clinical variables upon entry into the study. The results of therapy were categorized as cured, improved, or failed. The use of I-C resulted in an overall clinical response rate (cured and improved) of 91%, compared with an overall response rate with C+A of 73% (P = 0.15). Patients categorized as improved comprised 56.5% of those in the I-C group and 38.5% of those in the C+A group. Patients categorized as failed comprised 8.7% of those in the I-C group and 26.9% of those in the C+A group. Overall, these data support the use of I-C for the treatment of appropriate patients with postpartum endometritis.