Pelvic inflammatory disease and puerperal sepsis in Ethiopia. II. Treatment

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Clinical Pharmacology

Background:

• Serious gynecologic infections in Ethiopia are often treated empirically with penicillin and streptomycin (P/S) due to limited bacteriologic support.
• This practice necessitates a comparison with alternative antibiotic regimens to optimize patient outcomes.

Purpose of the Study:

• To compare the efficacy of penicillin and chloramphenicol (P/C) versus penicillin and streptomycin (P/S) for treating hospitalized women with bacteriologically confirmed pelvic inflammatory disease (PID) or puerperal sepsis (PPS).

Main Methods:

• A comparative study involving hospitalized women diagnosed with PID or PPS.
• Patients received either P/C or P/S antibiotic regimens.
• Efficacy was primarily assessed by the duration of fever and need for surgical intervention.

Main Results:

• Treatment of PPS with P/C was significantly more effective in reducing fever duration compared to P/S.
• Twenty-eight of 40 PPS patients required uterine evacuation for endometritis with retained products of conception.
• No significant difference in fever duration was observed between P/C and P/S for PID patients; 20 of 24 PID patients required surgical drainage of abscesses.

Conclusions:

• Penicillin and chloramphenicol (P/C) demonstrates superior efficacy over penicillin and streptomycin (P/S) in managing puerperal sepsis, particularly in reducing fever duration.
• Both P/C and P/S regimens showed comparable effectiveness for pelvic inflammatory disease, with a high rate of surgical intervention required for abscess management.