Abstract
Objective: The purpose of this study was to compare the clinical efficacy and safety of trospectomycin sulfate with that of clindamycin phosphate, both with aztreonam, for the treatment of obstetric and gynecologic infections.
Methods: In a double-blind, multicenter, prospective randomized study, 579 patients with either endometritis following cesarean delivery or pelvic cellulitis following hysterectomy were enrolled and received medication. Administered was either trospectomycin sulfate 500 mg IV every 8 h or clindamycin phosphate 900 mg IV every 8 h in a 1:1 randomization ratio. Both groups of patients received aztreonam 1 g IV every 8 h. The patients were followed for clinical responses and side effects.
Results: The cure rate for the trospectomycin sulfate arm was 91.8% and for clindamycin phosphate arm it was 88.4% (P = 0.218). The adverse events were similar in both groups.
Conclusions: Trospectomycin was as effective as clindamycin, when both were combined with aztreonam, in treatment of obstetric and gynecologic infections.
Full Text
The Full Text of this article is available as a PDF (478.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Appelbaum P. C., Spangler S. K., Jacobs M. R. Susceptibility of 539 gram-positive and gram-negative anaerobes to new agents, including RP59500, biapenem, trospectomycin and piperacillin/tazobactam. J Antimicrob Chemother. 1993 Aug;32(2):223–231. doi: 10.1093/jac/32.2.223. [DOI] [PubMed] [Google Scholar]
- Eschenbach D. A., Buchanan T. M., Pollock H. M., Forsyth P. S., Alexander E. R., Lin J. S., Wang S. P., Wentworth B. B., MacCormack W. M., Holmes K. K. Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med. 1975 Jul 24;293(4):166–171. doi: 10.1056/NEJM197507242930403. [DOI] [PubMed] [Google Scholar]
- Eschenbach D. A., Wager G. P. Puerperal infections. Clin Obstet Gynecol. 1980 Dec;23(4):1003–1037. doi: 10.1097/00003081-198012000-00006. [DOI] [PubMed] [Google Scholar]
- George W. L., Sutter V. L., Finegold S. M. Antimicrobial agent-induced diarrhea--a bacterial disease. J Infect Dis. 1977 Dec;136(6):822–828. doi: 10.1093/infdis/136.6.822. [DOI] [PubMed] [Google Scholar]
- Gibbs R. S. Infection after cesarean section. Clin Obstet Gynecol. 1985 Dec;28(4):697–710. doi: 10.1097/00003081-198528040-00003. [DOI] [PubMed] [Google Scholar]
- Ledger W. J., Norman M., Gee C., Lewis W. Bacteremia on an obstetric-gynecologic service. Am J Obstet Gynecol. 1975 Jan 15;121(2):205–212. doi: 10.1016/0002-9378(75)90641-9. [DOI] [PubMed] [Google Scholar]
- Ledger W. J., Puttler O. L. Death from pseudomembranous enterocolitis. Obstet Gynecol. 1975 Jun;45(6):609–613. doi: 10.1097/00006250-197506000-00002. [DOI] [PubMed] [Google Scholar]
- Stovall T. G., Thorpe E. M., Jr, Ling F. W. Treatment of post-cesarean section endometritis with ampicillin and sulbactam or clindamycin and gentamicin. J Reprod Med. 1993 Nov;38(11):843–848. [PubMed] [Google Scholar]
- Sweet R. L. Anaerobic infections of the female genital tract. Am J Obstet Gynecol. 1975 Aug 1;122(7):891–901. doi: 10.1016/0002-9378(75)90736-x. [DOI] [PubMed] [Google Scholar]
- Thadepalli H., Gorbach S. L., Keith L. Anaerobic infections of the female genital tract: bacteriologic and therapeutic aspects. Am J Obstet Gynecol. 1973 Dec 15;117(8):1034–1040. doi: 10.1016/0002-9378(73)90750-3. [DOI] [PubMed] [Google Scholar]
- Yagi B. H., Schaadt R. D., Zurenko G. E. The bactericidal activity and postantibiotic effect of trospectomycin. Diagn Microbiol Infect Dis. 1992 Jul;15(5):417–423. doi: 10.1016/0732-8893(92)90083-6. [DOI] [PubMed] [Google Scholar]
- Zurenko G. E., Yagi B. H., Vavra J. J., Wentworth B. B. In vitro antibacterial activity of trospectomycin (U-63366F), a novel spectinomycin analog. Antimicrob Agents Chemother. 1988 Feb;32(2):216–223. doi: 10.1128/aac.32.2.216. [DOI] [PMC free article] [PubMed] [Google Scholar]