Comparative evaluation of clindamycin versus clindamycin plus tobramycin in the treatment of acute pelvic inflammatory disease

Article Abstract:

Acute pelvic inflammatory disease, or acute salpingitis (inflammation of the fallopian tubes), can render a woman infertile, cause pain, or lead to ectopic pregnancy (in which the embryo becomes implanted outside the uterus). In addition, the disease recurs in 10 to 25 percent of cases. Since several infectious organisms appear to be present in these infections, two antibiotics are commonly administered simultaneously to provide broad coverage. Clindamycin as a single agent, and clindamycin plus tobramycin (antibiotic agents) were investigated for their efficacy in combatting acute pelvic inflammatory disease in 51 hospitalized women. The drugs were given intravenously for a minimum of four days in a randomized, prospective study (23 received clindamycin alone, 28 received both drugs). Cultures were grown from samples taken from the cervixes and the peritoneal (abdominal) cavity of all patients to determine which infectious organisms were present. Follow-up examinations and cultures were performed several weeks after hospital discharge to determine whether the agents had eliminated, or merely suppressed, the organisms. The previous history of pelvic inflammatory disease (61 percent in each group had none) and clinical findings of patients are briefly described. Results of drug treatment showed that all the patients in the combined drug group, and 91 percent (21 patients) of the clindamycin-only group, were successfully treated. Gonococcus (the organism responsible for gonorrhea) was found in 16 women and Chlamydia trachomatis in 15. These organisms were eliminated by the drug treatments, with the exception of one patient who did not test negative for gonococcus upon discharge, and two who did not test negative for C. trachomatis at follow-up. These patients were from both treatment groups, however. The results indicate that clindamycin alone is active against both gonococcus and C. trachomatis and is an effective treatment for pelvic inflammatory disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Salpingitis, Tobramycin

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A randomized comparison of gentamicin-clindamycin and cefoxitin-doxycycline in the treatment of acute pelvic inflammatory disease

Article Abstract:

Pelvic inflammatory disease (PID) is the swelling of the reproductive structures caused by a bacterial infection. Gonorrhea, Chlamydia trachomatis and mixed bacteria are the most common infections. Although the Centers for Disease Control suggest treating acute PID with combination antibiotic therapy, either cefoxitin plus doxycycline or gentamicin plus clindamycin, there is limited information regarding the overall therapeutic responses. Intravenous (IV) antibiotic therapy was given to 130 women with acute PID. The women were given either IV gentamicin plus clindamycin (63 women) followed by oral clindamycin (450 milligrams every six hours for 14 days), or cefoxitin plus doxycycline (67 women) followed by oral doxycycline (100 mg every 12 hours for 14 days). Gonorrhea was isolated from the cervixes of 46 women (35 percent) and chlamydia was isolated from 21 (16 percent). Mixed bacteria were generally isolated from the inside of the uterus. In all, 57 (90.5 percent) of the gentamicin-clindamycin-treated women were clinically cured and 64 (95.5 percent) of the cefoxitin-doxycycline-treated women were cured. The uterus or the fallopian tubes had to surgically removed in three patients who had received the gentamicin-clindamycin therapy and one women taking the cefoxitin-doxycycline therapy. All the gonorrhea cultures were negative at follow-up. Ten out 11 women who took gentamicin-clindamycin treatments who were available for follow-up were negative for Chlamydia, while 8 out of 9 women taking cefoxitin-doxycycline were negative for Chlamydia. The two combined antibiotic regimens were equally effective in eradicating gonorrhea and chlamydial infections in women with acute PID. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Gonorrhea, Chlamydia infections, Doxycycline, Gentamicin, Gentamicins, Cefoxitin

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Bacterial vaginosis: treatment with topical intravaginal clindamycin phosphate

Article Abstract:

Bacterial vaginosis (perhaps more accurately called vaginal bacteriosis) is a disease caused by an imbalance in the normal bacterial flora of the vagina. It is marked by an overgrowth of various bacteria such as Gardnerella vaginalis, which tends to replace the normal lactobacilli-dominated vagina. Bacterial vaginosis can be responsible for major diseases, ultimately affecting reproductive health. Treatment of bacterial vaginosis includes topical sulfonamide (vaginal cream) and oral metronidazole. Although metronidazole is effective in eradicating bacterial vaginosis, gastrointestinal side effects are very severe and some evidence in rat studies has emerged that the drug causes cancer. The efficacy of topical sulfonamide has lately been challenged. In an effort to find a more suitable treatment, the safety and efficacy of clindamycin phosphate antibiotic cream (0.1, 1.0, and 2.0 percent in the vagina twice a day for five days) are reported. Bacterial vaginosis was cured in four to seven days in 43 out of 46 women (93.5 percent) receiving clindamycin and only 4 out of 16 women (25 percent) using a placebo cream. All three doses had similar cure rates; however, 0.1 percent normalized the acidity of the vagina sooner and more effectively. One month later, 35 out of 39 women (89.7 percent) who were initially cured by clindamycin were still disease-free. None of the women receiving treatment stopped the medication because of side effects, which included limited local vaginal irritation. Topical clindamycin cream inserted into the vagina was a safe and effective treatment for bacterial vaginosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Dosage and administration, Vaginosis

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