Thirty‐six hospitalized patients, 18 in each of two groups, with postpartum upper genital tract infection were enrolled in a randomized, prospective study comparing treatment with sulbactam/ampicillin, to treatment with clindamycin/gentamicin. One (5.5%) clinical failure was reported in each group. Side effects were minimal in both groups and did not warrant discontinuation of treatment. The in vitro activity of ampicillin versus sulbactam/ampicillin (1: 2) was evaluated and these data were compared with data from other drugs commonly used for aerobic and anaerobic infections. Sulbactam eliminated resistance to ampicillin in all anaerobic and most aerobic isolates.
We evaluated the efficacy, patient and medical staff acceptance, and costs of intramuscular therapy with imipenem/cilastatin for mild to moderate upper reproductive tract infection in hospitalized women in an open study. Thirty-five patients were enrolled, and 29 successfully completed the protocol. Of these, 90% were satisfactorily treated with imipenem/cilastatin given intramuscularly. Twenty-eight of 29 subjects tolerated the intramuscular injections well, although 7 women noted mild to moderate discomfort during injection. All patients who had previously received intravenous therapy (24/29) stated that they preferred the intramuscular injections to continuation or reinitiation of intravenous treatment. Therapy with intramuscular imipenem/cilastatin (assuming a marketed price per gram of approximately $ 30) was associated with cost savings in comparison with other regimens offering similar antibacterial coverage. Initial care provider resistance to treatment with intramuscular imipenem/cilastatin was overcome due to patient satisfaction. Intramuscularly administered imipenem/cilastatin was effective, generally well tolerated, and resulted in cost saving. Intramuscular administration of imipenem/cilastatin may be a preferred antibiotic treatment in patients with mild to moderate infection due to susceptible microorganisms.
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