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Management of obstetric and gynecologic infections resulting from trauma.

Authors
  • Ledger, W J
Type
Published Article
Journal
Bulletin of the New York Academy of Medicine
Publication Date
Feb 01, 1979
Volume
55
Issue
2
Pages
241–247
Identifiers
PMID: 283861
Source
Medline
Keywords
License
Unknown

Abstract

Surgical procedures, abortion, and perforation by an intrauterine device (IUD) are the most prevalent obstetric and gynecologic injuries that may result in soft-tissue infection. Diagnosis and treatment must be aggressive because the abundant bacterial flora of the lower genital tract can serve as the inoculum for the serious soft-tissue pelvic infections. The large number of anaerobic organisms present contributes to the possibility of abscess formation if early antibiotic therapy is not appropriate and effective. Nevertheless, diagnosis is often difficult in a patient who becomes febrile within 48 hours of gynecologic surgery. Once diagnosis is made, however, the choice of an antibiotic depends on the severity of the illness and on the pathogens suspected of causing the infection. Because abdominal or vaginal hysterectomies crush tissue, the drug selected should provide a high-tissue level of antibiotic. Cultures should be taken before antibiotic therapy is started so that results are available if the patient does not respond to the initial antibiotic selected. Patients who are not severely ill or those who are allergic to penicillin may be traeted successfully with intravenous doxycycline. The author cites 3 clinical studies, including a total abdominal hysterectomy, a septic abortion, and an IUD perforation, which responded to this treatment.

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