Sulbactam/ampicillin versus cefoxitin in the treatment of gynaecological infections: an antibiotic therapeutic study

Abstract

Seventy-six women with gynaecological infections such as endometritis, salpingitis, tubo-ovarian abscess and pelvic peritonitis were treated with sulbactam/ampicillin (SBT/AMP) (50% of patients) or cefoxitin (CFN) (50% of patients) in a randomized, controlled study. The diagnosis was based on the history, clinical findings and microbiological culture findings. The disease was assumed to be of bacterial origin if leukocytosis was present with a left shift or if the causative organism was identified. Of the group of patients treated with SBT/AMP, 33 (87%) were cured and 4 (10.5%) showed improvement; 1 patient (2.5%) failed to respond to treatment. The equivalent figures for the CFN group were: 30 patients (79%) cured, 4 (10.5%) showed improvement and 4 (10.5%) failed to respond to treatment. The causative organism was eradicated in 29 (91%) patients in the SBT/AMP group and 20 (59%) patients in the CFN group. Reinfection occurred in 1 (3%) patient in the SBT/AMP group and 4 (12%) patients in the CFN group. The causative organism persisted in 1 (3%) patient in the SBT/AMP group and 4(12%) patients in the CFN group. The superiority of SBT/AMP in microbiological terms was statistically significant, but the superiority of SBT/AMP in terms of clinical efficacy was not. The combination of SBT and AMP was efficacious and well tolerated in the treatment of gynaecological infections. This combination offers the advantage of being effective against Streptococcus faecalis and beta-lactamase producing organisms.