ABSTRACT
Although intrapartum antibiotics are beneficial to both the mother and newborn, there
is no consensus as to the most efficacious antibiotic regimen in the treatment of
intra-amnionic infection, especially with regard to anaerobic coverage. We randomized
pregnant women with intra-amnionic infection to receive either dual agent therapy
(ampicillin and gentamicin) or triple agent therapy (ampicillin, gentamicin, and clindamycin).
The frequency of vaginal and cesarean delivery was similar in both groups. There was
no significant difference in the incidence of endometritis between the two groups
(10 of 69 versus 5 of 64; p = NS). There were no significant differences in either
neonatal morbidity or mortality. The addition of clindamycin to provide anaerobic
coverage for intra-amnionic infection does not significantly alter the incidence of
endometritis in women delivered by cesarean section, although it may have an impact
on women delivering vaginally.
