Failure of β-lactam antibiotics to eradicate Chlamydia trachomatis in the endometrium despite apparent clinical cure of acute salpingitis

Richard L Sweet, J. Schachter, M. O. Robbie

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Abstract

Chlamydia trachomatis was isolated from 17 (24%) of 71 patients with acute salpingitis (AS) hospitalized for parenteral treatment. For patients with AS, antimicrobial therapy was started immediately on admission and before the availability of culture results. Notable clinical response was seen in 16 of 17 chlamydial-positive cases. Despite apparent clinical cure, posttreatment cultures from the endometrial cavity yielded C. trachomatis from 12 of 13 patients treated solely with second- or third-generation cephalosporins as single-agent therapy. The finding of persistent chlamydial infection of the endometrium suggests that some patients treated for AS, despite apparent clinical response, maintain chlamydial infection of the endometrium that might cause relapse or chronic fallopian tube infection with tubal obstruction and infertility, or perhaps reflect a similar tubal persistence of Chlamydia. Treatment of AS should routinely include coverage for C. trachomatis, as clinical response and findings may not reflect its presence or persistence.

Original languageEnglish (US)
Pages (from-to)2641-2645
Number of pages5
JournalJournal of the American Medical Association
Volume250
Issue number19
DOIs
StatePublished - 1983

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Salpingitis
Lactams
Chlamydia trachomatis
Endometrium
Anti-Bacterial Agents
Fallopian Tube Diseases
Infection
Fallopian Tubes
Chlamydia
Cephalosporins
Therapeutics
Infertility
Recurrence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Failure of β-lactam antibiotics to eradicate Chlamydia trachomatis in the endometrium despite apparent clinical cure of acute salpingitis",
abstract = "Chlamydia trachomatis was isolated from 17 (24{\%}) of 71 patients with acute salpingitis (AS) hospitalized for parenteral treatment. For patients with AS, antimicrobial therapy was started immediately on admission and before the availability of culture results. Notable clinical response was seen in 16 of 17 chlamydial-positive cases. Despite apparent clinical cure, posttreatment cultures from the endometrial cavity yielded C. trachomatis from 12 of 13 patients treated solely with second- or third-generation cephalosporins as single-agent therapy. The finding of persistent chlamydial infection of the endometrium suggests that some patients treated for AS, despite apparent clinical response, maintain chlamydial infection of the endometrium that might cause relapse or chronic fallopian tube infection with tubal obstruction and infertility, or perhaps reflect a similar tubal persistence of Chlamydia. Treatment of AS should routinely include coverage for C. trachomatis, as clinical response and findings may not reflect its presence or persistence.",
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N2 - Chlamydia trachomatis was isolated from 17 (24%) of 71 patients with acute salpingitis (AS) hospitalized for parenteral treatment. For patients with AS, antimicrobial therapy was started immediately on admission and before the availability of culture results. Notable clinical response was seen in 16 of 17 chlamydial-positive cases. Despite apparent clinical cure, posttreatment cultures from the endometrial cavity yielded C. trachomatis from 12 of 13 patients treated solely with second- or third-generation cephalosporins as single-agent therapy. The finding of persistent chlamydial infection of the endometrium suggests that some patients treated for AS, despite apparent clinical response, maintain chlamydial infection of the endometrium that might cause relapse or chronic fallopian tube infection with tubal obstruction and infertility, or perhaps reflect a similar tubal persistence of Chlamydia. Treatment of AS should routinely include coverage for C. trachomatis, as clinical response and findings may not reflect its presence or persistence.

AB - Chlamydia trachomatis was isolated from 17 (24%) of 71 patients with acute salpingitis (AS) hospitalized for parenteral treatment. For patients with AS, antimicrobial therapy was started immediately on admission and before the availability of culture results. Notable clinical response was seen in 16 of 17 chlamydial-positive cases. Despite apparent clinical cure, posttreatment cultures from the endometrial cavity yielded C. trachomatis from 12 of 13 patients treated solely with second- or third-generation cephalosporins as single-agent therapy. The finding of persistent chlamydial infection of the endometrium suggests that some patients treated for AS, despite apparent clinical response, maintain chlamydial infection of the endometrium that might cause relapse or chronic fallopian tube infection with tubal obstruction and infertility, or perhaps reflect a similar tubal persistence of Chlamydia. Treatment of AS should routinely include coverage for C. trachomatis, as clinical response and findings may not reflect its presence or persistence.

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