Antibiotic treatment of tuboovarian abscess: comparison of broad-spectrum beta-lactam agents versus clindamycin-containing regimens

An abscess is an area of infected tissue that is swollen with pus and dead tissue. When pelvic infections occur, but are not treated properly, they lead to abscess formation in the female reproductive tract (tuboovarian abscess). This condition can be very serious if left untreated. In the past, before suitable antibiotics were available, this type of abscess was treated surgically, and was associated with high mortality caused by rupture of the abscess. Today, antibiotics, such as clindamycin and metronidazole, are considered to be the best treatment for tuboovarian abscesses. To evaluate the effectiveness of different antibiotics in treating tuboovarian abscesses the following three groups were studied: 37 patients were treated with a combination of cefoxitin and doxycycline (group 1); 64 patients were treated with either clindamycin and tobramycin or clindamycin and gentamicin (group 2); and an additional 18 patients were treated with cefoxitin and doxycycline for two to three days and then switched to clindamycin and tobramycin or clindamycin and gentamicin. Eighty-four percent of those in group 1; 70 percent of those in group 2; and 78 percent of those in group 3 were treated successfully with antibiotic therapy. The rest of the patients required surgery to remove the abscess. The larger abscesses were less likely to respond to treatment with antibiotics and were more likely to require surgery. The results of this study indicate that tuboovarian abscesses can be successfully treated by each of these three antibiotic regimens, and that surgery is not required in all cases. (Consumer Summary produced by Reliance Medical Information, Inc.)