Predominant sexually transmitted diseases among different age and ethnic groups of indigent sexually active adolescents attending a family planning clinic.

The present study analyzed a group of 113 sexually active, indigent female adolescents attending a family planning clinic, for age, ethnic, or racial trends in the recovery of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma species, and Ureaplasma urealyticum. The overall recovery rate for N. gonorrhoeae was 8/112 (7.

Ticarcillin disodium/clavulanate potassium versus clindamycin/gentamicin in the treatment of postpartum endometritis.

Ticarcillin disodium/clavulanate potassium was compared to clindamycin/gentamicin in the treatment of post-cesarean-section endometritis in 133 evaluable patients. All patients received three 1-g doses of cefazolin for prophylaxis. There was no statistically significant difference in the cure rates between the ticarcillin disodium/clavulanate potassium group (84%) and the clindamycin/gentamicin group (81%).

Antibiotic usage in pelvic infections. An overview.

Postoperative soft-tissue pelvic infections in women most commonly are polymicrobial and mixed aerobic and anaerobic. Antibiotic prophylaxis has been advocated to reduce the risk of postcesarean endometritis and post-vaginal hysterectomy pelvic infection. The use of antibiotic prophylaxis has a tendency to select for resistant bacteria, and many of those bacteria produce beta-lactamase.

Premarket evaluation of Monofluor reagent for detecting Chlamydia trachomatis in adolescent outpatients.

A new direct fluorescent antibody reagent, Monofluor, was evaluated for detecting Chlamydia trachomatis in fresh specimens. Monofluor was compared with Micro Trak and with cultivation in McCoy cells. Both direct systems were slightly less sensitive than culture, but no significant differences in specificity or sensitivity were noted between culture, Monofluor, or Micro Trak results.

Randomized double-blind comparison of mezlocillin versus cefoxitin prophylaxis for vaginal hysterectomy.

One hundred patients undergoing vaginal hysterectomy were enrolled in a randomized double-blind comparative antibiotic prophylaxis study. Forty-six patients received mezlocillin and 54 patients received cefoxitin. No significant difference was found among patients who developed febrile morbidity.

Favorable outcome after treatment with amantadine and ribavirin in a pregnancy complicated by influenza pneumonia. A case report.

The moderate impairment of cell-mediated immunity that occurs in pregnancy justifies concern when a pregnant woman develops influenza. We treated a woman for influenza pneumonia with respiratory failure at 33 weeks' gestation with oral amantadine and ribavirin inhalation therapy in conjunction with evacuation of the uterus and delivery.

Correlation of ultrasonography and bacteriology of the endocervix and posterior cul-de-sac of patients with severe pelvic inflammatory disease.

We evaluated 30 patients admitted with a diagnosis of pelvic inflammatory disease (PID) by culdocentesis and ultrasonography to determine the severity of disease in relation to endocervical and culdocentesis bacteriology. Specimens from the endocervix were cultured for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum. In addition, culdocentesis fluid was cultured for aerobes and anaerobes.

Perspectives on the bacteriology of postoperative obstetric-gynecologic infections.

The development of postoperative infections is influenced by both host and external factors. The present report focuses on the influence of prophylactic agents on the apparent cause of infection after cesarean section and vaginal hysterectomy. The correlation between in vitro susceptibility patterns of potential pathogens and normal flora and in vivo response is also considered.

Lymphocytes proliferation kinetics and SCE variation after rubella vaccination.

The effect of anti-rubella vaccination on lymphocyte proliferation kinetics in vitro and on SCE frequency was studied in three young women. The studies were carried out by taking blood samples before vaccination (day 0) and subsequently on days 7, 14, 28 and 42. The mitotic index (MI) shows a decrease at day 14 and 28 followed at day 42 by an increase above day 0 levels.

Results of noncomparative studies of cefotetan in the treatment of obstetric and gynecologic infections.

In a multicenter trial involving 11 centers, 160 women were enrolled to evaluate the safety and effectiveness of 1 or 2 gm of cefotetan administered every 12 hours in the treatment of obstetric and gynecologic infections. The 133 evaluable patients generally were under 25 years of age, were nonwhite, and had hospital-acquired endometritis or pelvic inflammatory disease caused by both aerobic and anaerobic bacteria. Escherichia coli, Neisseria gonorrhoeae, group D streptococci, Bacteroides sp.

Prevention of infections after obstetric and gynecologic surgery.

The need for antimicrobial prophylaxis in patients undergoing vaginal hysterectomy is well recognized, and the benefits of prophylaxis in cesarean section are relatively clear-cut. In contrast, only those patients at risk of serious complications from postoperative infection are considered candidates for prophylaxis after abdominal hysterectomy. This paper addresses the following questions: Does the patient need prophylaxis? If so, how should the most suitable antibiotic be selected?

Pharmacokinetics of the acyclureidopenicillins piperacillin and mezlocillin in the postpartum patient.

The postpartum patient experiences numerous physiologic alterations, which may affect the pharmacokinetics of certain drugs. Six patients received either piperacillin or mezlocillin intravenously immediately after delivery. Serum half-life and clearance were, respectively, 82.

Gardnerella vaginalis chorioamnionitis: a report of two cases and a review of the pathogenic role of G. vaginalis in obstetrics.

Two patients with chorioamnionitis due to Gardnerella vaginalis are described. Institution of tocolytic therapy for preterm labor is associated with maternal complications of septic hypotension and pulmonary edema in one patient. Diagnostic modalities, specifically culturing techniques, are discussed, as well as suspected pathophysiologic mechanisms.

Moxalactam versus clindamycin plus tobramycin for the treatment of puerperal infections.

Sixty women with the diagnosis of puerperal endometritis were randomized to receive either moxalactam (n = 29) or the combination of clindamycin and tobramycin (n = 31) as therapy for their infection. Endometrial bacteriology consisted of mixed flora, both aerobic and anaerobic gram-positive and gram-negative organisms. Clinical cure was achieved in 27 (93%) of the moxalactam-treated patients and 28 (90%) of those given combination therapy.

Postcesarean wound infection by Mycoplasma hominis in a patient with persistent postpartum fever.

Mycoplasma hominis was isolated in pure culture from a wound infection following delivery by cesarean section. The importance of recognizing this organism as a potential pathogen of the female genital tract is emphasized. Two commercially available isolation systems that allow the recovery of this organism are also described.

Comparative efficacy and safety of mezlocillin, cefoxitin, and clindamycin plus gentamicin in postpartum endometritis.

The efficacy of mezlocillin versus cefoxitin versus clindamycin plus gentamicin was evaluated in 152 patients with postpartum endometritis. There were no statistically significant differences in rate of cure among the three groups (87% with mezlocillin, 82% with cefoxitin, and 92% with clindamycin-gentamicin). There were no severe adverse reactions observed in any of the three treatment regimens.

Severe uterine hemorrhage from blastomycosis of the endometrium. A case report.

A 32-year-old black woman presented in the emergency room with vaginal bleeding. Physical examination revealed a granulomatous lesion on the thigh and a breast abscess. Histopathologic examination and culture of an endometrial biopsy revealed Blastomyces dermatitidis.

Pyelonephritis associated with respiratory distress.

We present a case of pyelonephritis associated with respiratory distress and elevated liver enzymes in a pregnant patient.

Non-specific vaginitis or vaginitis of undetermined aetiology.

Vaginitis is a complex syndrome that is probably the most common outpatient disease seen by the gynaecologist. The specific aetiologies of vaginitis are many. One of the most common entities, however, is "non-specific vaginitis" which can be subdivided into: Gardnerella vaginitis, anaerobic vaginosis, and vaginitis of undetermined aetiology.

A comparison of piperacillin, cephalothin and cefoxitin in the prevention of postoperative infections in patients undergoing vaginal hysterectomy.

A randomized, double-blind, multicenter trial was initiated to compare the safety and efficacy of piperacillin, cephalothin and cefoxitin in the prophylactic treatment of patients undergoing vaginal hysterectomy. The total dose of each antibiotic was 6 grams given in three equally divided doses. A satisfactory prophylactic response was obtained in 143 of 151 (95 per cent) patients treated with piperacillin, in 82 of 87 (94 per cent) patients treated with cephalothin and in 57 of 60 (95 per cent) patients treated with cefoxitin.

Treatment of disseminated herpes simplex virus in pregnancy with parenteral acyclovir. A case report.

Disseminated herpes simplex virus infection in a pregnant woman was successfully treated with acyclovir. Similar reported cases have suggested that acyclovir may be suitable for the treatment of disseminated or severe primary herpes in pregnant women.

Isolation of Mycoplasma species and Ureaplasma urealyticum from obstetrical and gynecological patients by using commercially available medium formulations.

One hundred duplicate endocervical specimens from obstetrical and gynecological patients were cultured for Mycoplasma spp. and Ureaplasma urealyticum. Rates of recovery of these organisms from commercially prepared A7 medium and the Mycotrim-GU system were compared.