Pelvic tissue and serum concentrations of various antibiotics given as pre-operative medication

Talampicillin, cephalexin and clindamycin were administered orally, and ampicillin, cephazolin, clindamycin and spectinomycin intramuscularly as preoperative medication to 49 women who were having an abdominal hysterectomy. Antibiotic levels in serum, myometrium or cervix, and Fallopian tube were estimated. Antibiotic absorption from the gastrointestinal tract was delayed, but intramuscular therapy produced serum levels compatible with those reported in ambulant volunteers. None of the antibiotics produced a concentration which inhibited all the potential pathogens causing pelvic inflammatory disease. Inhibitory concentrations were produced by cephazolin except against Bacteroides; by clindamycin except against enterobacteria; by ampicillin except against Bacteroides and enterobacteria; and by spectinomycin except against resistant strains of streptococci. The need for a reassessment of dose regimens and route of administration as well as the possible need for using two antibiotics together for the treatment of pelvic inflammatory disease is suggested.