A randomized trial of ofloxacin versus cefoxitin and doxycycline in the outpatient treatment of acute salpingitis

Article Abstract:

Acute salpingitis is the inflammation of the fallopian tubes, which extend from the uterus toward the ovaries. This infection is usually caused by Neisseria gonorrhoeae, Chlamydia trachomatis, and other aerobic and anaerobic bacteria. Sequential antibiotic regimens, involving the administration of an antigonococcal agent for a given time period followed by an antichlamydial agent for a given time period, are used to treat nonhospitalized patients (outpatients) with acute salpingitis. The antibiotics tetracycline, doxycycline, amoxicillin, and clindamycin may be used in combined regimens to treat C. trachomatis infection. However, the newer fluoroquinolones have been shown to be effective as single agents in treating sexually transmitted diseases. Studies show that gonorrhea and chlamydial infections can be successfully treated with the fluoroquinolone ofloxacin. The safety and effectiveness of ofloxacin in treating acute salpingitis were assessed. The results were compared with those obtained after treatment with cefoxitin combined with probenecid, followed by doxycycline. The study involved 72 women with acute salpingitis, including 38 cases of N. gonorrhoeae infection and 18 cases of C. trachomatis infection, confirmed by bacterial culture. Acute salpingitis was successfully treated in 35 of 37 women treated with ofloxacin and 34 of 35 treated with the cefoxitin-doxycycline regimen. Acute salpingitis was not treated in two patients infected with N. gonorrhoeae, including one treated with ofloxacin and one treated with the combined therapy. Gonococcal infection was not eliminated in another ofloxacin-treated patient due to drug-related side effects. Both drug regimens were 100 percent effective in treating N. gonorrhoeae, whereas elimination of C. trachomatis was 100 percent for cefoxitin-doxycycline patients and 86 percent for ofloxacin-treated patients. The two drug regimens caused similar side effects. These findings demonstrate that both the ofloxacin and cefoxitin-doxycycline regimens are effective in treating outpatients with acute salpingitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Antibiotics, Drug therapy, Doxycycline, Salpingitis, Ofloxacin, Cefoxitin

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Markers of acute and chronic asphyxia in infants with meconium-stained amniotic fluid

Article Abstract:

The presence of meconium in the amniotic fluid during labor does not appear to be associated with a lack of oxygen called asphyxia. Meconium is a baby's first stool. Umbilical-cord blood was assayed for lactate, hypoxanthine, and erythropoietin, and concentrations were compared between 28 healthy women in labor with meconium-stained amniotic fluid and 28 similar women with clear amniotic fluid. Fetuses with meconium-stained fluid were older than fetuses that did not pass meconium. This supports the theory that meconium passage relates to maturation of the digestive tract. No fetus showed any signs of fetal distress in labor, and Apgar scores and blood pH, a measure of oxygenation, were similar. Lactate levels and hypoxanthine levels, which are indicators of recent asphyxia, were similar. However, erythropoietin levels were higher in cases of meconium staining. Erythropoietin level appears to correlate with chronic stress or stress in the more distant past.

Physiological aspects, Asphyxia neonatorum, Erythropoietin, Meconium

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Ampicillin for neonatal group B streptococcal prophylaxis: how rapidly can bactericidal concentrations be achieved?

Article Abstract:

Intravenous ampicillin appears to reach concentrations capable of killing group B streptococci in fetal blood and amniotic fluid within minutes after maternal administration. Researchers administered intravenous ampicillin to 40 women between 3 and 67 minutes before having an elective cesarean section. Samples of amniotic fluid and maternal and umbilical cord blood were taken before making the uterine incision. Ampicillin concentrations achieved levels capable of killing group B streptococci as soon as five minutes in blood and amniotic fluid. However, amniotic fluid levels did not achieve this concentration in 15% of cases.

Health aspects, Analysis, Streptococcal infections, Prevention, Complications and side effects, Cesarean section, Amniotic fluid, Ampicillin

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