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Piperacillin Versus Clindamycin Plus Gentamicin for Pelvic Infections

From the Departments of Obstetrics and Gynecology, Wilford Hall U.S. Air Force Medical Center, Lackland Air Force Base, Texas, and University of Texas, Health Science Center at San Antonio, San Antonio, Texas.

Piperacillin, a new semisynthetic penicillin, has broad spectrum activity against most clinically important aerobic and anaerobic bacteria. In the present study, piperacillin was compared with a combination of clindamycin and gentamicin for the treatment of 83 women with pelvic infection (42 with endometritis, 29 with posthysterectomy cuff infections, 11 with acute salpingitis, and one with a wound infection). There were 179 bacterial isolates, 98 (53%) aerobic and 81 (45%) anaerobic. Of the 42 patients treated with piperacillin, there were three (7.1%) clinical failures compared with one (2.4%) in the 41 patients treated with clindamycin-gentamicin. A single drug, piperacillin, was shown to be as safe and effective as the combined clindamycin plus gentamicin therapy for pelvic infections.