Introduction: Infected abortion is a life-threatening condition that requires immediate surgical and medical interventions. We aimed to assess the common pathogens associated with infected abortion and to test the microbial coverage of various empiric antimicrobial regimens based on the bacteriological susceptibility results in women with infected abortions.
Methods: A retrospective study in a single university-affiliated tertiary hospital. Electronic records were searched for clinical course, microbial characteristics, and antibiotic susceptibility of all patients diagnosed with an infected abortion. The effectiveness of five antibiotic regimens was analyzed according to bacteriological susceptibility results.
Results: Overall, 84 patients were included in the study. The mean age of patients was 32.3(SD ± 5.8) years, and the median gestational age was 15 (IQR 8-19) weeks. Risk factors for infection were identified in 23 patients (27.3%), and included lack of medical insurance (n = 12), recent amniocentesis/chorionic villus sampling or fetal reduction due to multifetal pregnancies (n = 10). The most common pathogens isolated were Enterobacteriaceae (35%), Streptococci (31%), Staphylococci (9%) and Enterococci (9%). The combination of intravenous ampicillin, gentamicin and metronidazole showed significant superiority over all the other tested regimens according to the susceptibility test results. Piperacillin-tazobactam as an empiric single-agent drug of choice and provided a superior microbial coverage, with a coverage rate of 93.3%.
Conclusions: A combination of ampicillin, gentamicin, and metronidazole had a better spectrum of coverage as a first-line empiric choice for patients with infected abortion.
Keywords: Antibiotics; Infected abortion; Microbiology; Septic abortion.
Copyright © 2019. Published by Elsevier Inc.
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Deep neck abscess: an analysis of microbial etiology and the effectiveness of antibiotics.Infect Drug Resist. 2008;1:1-8. doi: 10.2147/idr.s3554. Epub 2008 Jul 7. Infect Drug Resist. 2008. PMID: 21694873 Free PMC article.
Adequacy of empiric gram-negative coverage for septic patients at an academic medical center.Am J Infect Control. 2019 Oct;47(10):1194-1199. doi: 10.1016/j.ajic.2019.03.037. Epub 2019 May 18. Am J Infect Control. 2019. PMID: 31109743
Antibiotic regimens for management of intra-amniotic infection.Cochrane Database Syst Rev. 2014 Dec 19;(12):CD010976. doi: 10.1002/14651858.CD010976.pub2. Cochrane Database Syst Rev. 2014. PMID: 25526426 Review.
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