Cefamandole nafate has been shown to have good in vitro activity against a wide spectrum of aerobic and anaerobic pathogens frequently isolated from women with obstetrical and gynecological
infections. One hundred and twenty seven women with these
infections were treated with
cefamandole: 78 had post-
cesarean section metritis; 24 acute
pelvic inflammatory disease; 18 post-
hysterectomy cuff
cellulitis/
abscess; and 7 had vulvar or abdominal
wound abscesses. All but 13% of these women had either polymicrobial aerobic/anaerobic
bacterial infections, or had an anaerobic
infection alone. Of these 127 women, 116 responded to
cefamandole administration alone, and in the other 11
chloramphenicol was added. Of these 11, surgical
therapy was necessary to eradicate
infection in six women.
Phlebitis, mild to severe, was demonstrated in 14% of the women and responded to conservative measures. Of 402 bacterial isolates from these women, 94% were sensitive to
cefamandole at 32 microgram/ml, an easily achievable serum level. Anaerobic streptococci were the most common isolate and 94% of these organisms were sensitive at 32 microgram/ml. Of the 43 Bacteroides species isolated, 90% were susceptible at 32 microgram/ml; 84% of Bacteroides fragilis were susceptible ast this concentration. Data now presented indicate that
cefamandole given alone is safe and effective for treatment of women with polymicrobial mixed aerobic/anaerobic
pelvic infections and approximately 5% will require surgical
therapy for eradication of these
infections.