EARLY POSTPARTUM ENDOMETRITIS - RANDOMIZED COMPARISON OF AMPICILLIN SULBACTAM VS AMPICILLIN, GENTAMICIN AND CLINDAMYCIN/

Seventy-six parturients with a clinical diagnosis of early postpartum endometritis were randomized to be treated with either standard therap y-ampicillin, gentamicin and clindamycin-or a new regimen, ampicillin/ sulbactam. We deliberately chose to administer 1;5 g of ampicillin/sul bactam rather than a 3-g dose every sir hours in order to accentuate a ny differences that might occur between the regimens. Failure rates, d ays of therapy and cost of treatment were compared. There was no stati stically significant difference (P > .9) in the failure or recovery ra tes: 4 of 42 (9.5%) patients failed standard therapy vs. 6 of 34 (17.6 %) patients in the ampicillin/sulbactam group. The rimes to recovery w ere 3.6 +/- 1.8 SD and 3.3 +/- 1.3 days, respectively. There was no di fference in side effects or drug toxicity between the two groups. The cost of standard therapy wets $355.32 for 3.6 days, whereas ampicillin /sulbactam cost $139.49 for 3.3 days. Therapy with ampicillin/sulbacta m may be an equally effective and efficient way to treat patients with early postpartum endometritis.