Most appropriate initial therapy for Postpartum Endometritis is:
A . Clindamycin&metronidazole
B . Vancomycin&gentamycin
C . Ceftriaxone&azithromycin
D . Clindamycin&gentamycin
Answer: D
Explanation:
The prevention of endometritis is important. Infection prevention practices, including avoiding unnecessary caesarean section, appropriate management of prolonged labour, fewer vaginal examinations during labour, use of good sterile techniques and meticulous operative procedures during delivery, and providing appropriate prophylactic antibiotics during caesarean section should be routinely practiced. FIRST CONTACT (PRIMARY CARE LEVEL) The diagnosis of endometritis should be considered when a postpartum woman has febrile morbidity (oral temperature ≥38.0°C or on two occasions between day 1-10 after birth) abdominal pain or foul smelling lochia. Careful physical examination to detect the source of infection is crucial. Once endometritis is diagnosed, appropriate antibiotic treatment should be started. If clindamicin is not available, or not affordable, the WHO-recommended regimen of ampicillin plus gentamicin plus metronidazole should be used. If fever is still present 72 hours after treatment, the patient should be carefully re-evaluated and the diagnosis revised. If complication(s) (such as pelvic abscess, peritonitis, septic shock, etc.) are suspected the patient should be referred to higher level of health care immediately.
Reference:
http://apps.who.int/rhl/pregnancy_childbirth/care_after_childbirth/ccguide/en/