Comparative bacteriology of parenteral single-agent vs. combination therapy in salpingitis

Protected devices recovered bacteria from the endometrium of 119 women with acute salpingitis prior to and after clinically successful parenteral antimicrobial therapy in a prospective, randomized clinical trial. Single-agent antimicrobial therapy in a prospective, randomized clinical trial. Single-agent therapy consisted of ceftizoxime given at two different dosing intervals. Intravenous doxycycline was also added to twice-daily ceftizoxime or cefoxitin 4 times daily. The 52% overall reduction in aerobic and anaerobic bacterial species recovered after therapy was similar for all four regimens (p=0.169). Neither more frequent dosing of ceftizoxime nor the addition of doxycycline resulted in more effective eradication of isolates. Significantly more bacteria were resistant in vitro to doxycycline than to the coadministered ceftizoxime (p<0.001) or cefoxitin (p=0.005). Doxycycline did not add sufficient antibacterial activity to warrant its intravenous administration.