Endometritis is inflammation of the inner lining of the uterus that can result from a sexually transmitted infection such as chlamydia or gonorrhea, but most often occurs after a miscarriage or childbirth involving prolonged labor or a cesarean section. Symptoms include abdominal swelling, fever and abnormal vaginal discharge or bleeding. Endometritis responds well to prompt treatment with intravenous antibiotics.
Piperacillin-Tazobactam (Zosyn)
Piperacillin-tazobactam is a combination antibiotic that is administered by intravenous infusion in cases of postpartum endometritis. On each day of treatment, patients receive this antibiotic every six hours, and the treatment usually lasts seven to 10 days. Women who are nursing should be aware that small amounts of piperacillin have been found in human milk. The most common side effects of piperacillin-tazobactam therapy include diarrhea, headache, nausea, insomnia, rash, vomiting, itching, agitation and dizziness.
Ceftazidime (Fortaz)
Ceftazidime is an injectable antibiotic that is in the cephalosporin class of prescription medications. It is indicated for use in patients with gynecological infections such as endometritis. These patients will generally receive the drug intravenously every eight hours. Doctors should exercise caution in the admininstration of ceftazidime to patients with impaired kidney function because blood levels of the drug in these patients can remain high for prolonged periods of time. This situation can lead to serious side effects such as seizures, coma, alterations in brain function and structure, and uncontrolled muscle spasms. In patients with normal kidney and liver function, side effects of ceftazidime are minor and include inflammation at the site of injection, itching, rash, nausea and diarrhea.
Clindamycin and Gentamicin
Clindamycin is a prescription medication that is in the lincosamide class of antibiotics. It works by preventing bacteria from synthesizing needed proteins, and is a good alternative for patients who are allergic to penicillin. A serious side effect associated with clindamycin is pseudomembranous colitis which is an inflammation of the large intestine. Gentamicin is in the aminoglycoside class of antibiotics, and can treat serious Gram-negative bacterial infections. Patients taking gentamicin need to be monitored for kidney and neuronal toxicity.
When treating endometritis, clindamycin and gentamicin are administered intravenously separately three times daily until the patient is without fever for more than 24 hours. In most instances, patients will show improvement in their conditions within two to three days.
