Comment: The quality of evidence is downgraded by study limitations (poor quality and the latest was done 1996).
A Cochrane review [Abstract] 1 included 40 studies with a total of 4 240 subjects. Fifteen studies comparing clindamycin and an aminoglycoside with another regimen showed more treatment failures with the other regimen (relative risk [RR] 1.44; 95% confidence interval [CI] 1.15 to 1.80; 19 trials, n=1902). Failures of those regiments with poor activity against penicillin resistant anaerobic bacteria were more likely (RR 1.94; 95% CI 1.38 to 2.72). Beta-lactamase inhibitor combination versus any other regimen showed no significant difference (RR 1.00, 95% CI 0.89 to 1.14; 12 trials, n=1007). Cephalosporins were associated with less diarrhea. In three studies that compared continued oral antibiotic therapy after intravenous therapy with no oral therapy, no differences were found in recurrent endometritis or other outcomes. In four studies comparing once daily with thrice daily dosing of gentamicin there were fewer failures with once daily dosing.
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