RHL Commentary by Chompilas Chongsomchai
EVIDENCE SUMMARY
Thirty-eight randomized trials of different antibiotic regimens for the treatment of postpartum endometritis after caesarean section or vaginal delivery were included in this review. The main outcome measures in these trials were treatment failure, complications and side-effects. A combination of clindamycin and gentamycin was associated with statistically significantly fewer treatment failures than other antibiotics. (Four trials, 463 women, relative risk [RR]: 0.70; 95% confidence interval [CI]: 1.09–1.00) There were fewer failures with once daily dosage of gentamycin compared with a thrice daily dosage. Regimens of antibiotics not active against penicillin-resistant anaerobic bacteria had significantly more treatment failures. Overall, there were no differences between the antibiotics in terms of side-effects, except for significantly less diarrhoea with second and third generation cephalosporins. Continuation of intravenous treatment with oral treatment did not yield any additional benefits.
All randomized trials which met eligibility criteria specified in the protocol were included and appropriately analysed. A subgroup analysis of the antibiotics by route of delivery could not be conducted owing to lack of adequate data.
The full RHL commentary also includes sections on: Relevance
- Magnitude of the problem
- Applicability of the results
- Implementation of the intervention
Research
References
This document should be cited as: Chompilas Chongsomchai. Antibiotic regimens for endometritis after delivery: RHL commentary (last revised: 27 October 2004). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com
|
