Treatment of obstetric and gynecologic infections, with an emphasis on beta-lactamase-producing organisms

The ideal pharmaceutical treatment for pelvic infections in women should provide good antibacterial coverage, have proven efficacy and be associated with a good outcome in terms of fertility and organ preservation. In an open study, ticarcillin disodium/clavulanate potassium was used to treat upper genital tract infections in 91 women. The clinical success rate was 92% with outpatient-acquired pelvic inflammatory disease; 50% with tuboovarian abscess, as confirmed by ultrasound; 85% with postpartum endometritis; 88% with endometritis plus chorioamnionitis; and 90% with postoperative infection, including cesarean section. The primary adverse reaction was diarrhea, in ten patients. Among the 129 aerobes isolated, 18 (14%) were beta-lactamase positive, as were 32% (20/63) of the anaerobes.