2294. Comparative Evaluation of Ertapenem and Clindamycin Plus Gentamicin for the Treatment of Postpartum Endometritis

Abstract

BackgroundClindamycin plus gentamicin (C/G) is the most commonly used regimen for the treatment of postpartum endometritis. With a similar spectrum of coverage and once daily dosing, ertapenem is an attractive alternative. The purpose of this study was to evaluate the efficacy of ertapenem compared with C/G, for the treatment of postpartum endometritis.MethodsThis was a retrospective chart review (IRB-approved) of patients treated with either ertapenem or C/G for endometritis, from July 2017 to July 2018. Patients receiving agents from both groups were excluded. Data collected included: demographics, ante- and intrapartum course, including efficacy parameters and antimicrobial use. Secondary objectives included a safety outcomes and patient quality analysis. Appropriate statistical analysis was performed.ResultsA total of 81 patients were included (40 in C/G arm, 41 in ertapenem arm). No differences in mean length of stay (5.98 vs. 5.61 days in C/G and ertapenem, P = 0.61), readmission within 14 days, or mortality were seen. No patients developed acute kidney injury, C. difficile infection, or ototoxicity. All patients in the ertapenem arm had appropriate dosing, compared with 27.5% in C/G arm (P < 0.0001). Inappropriate dosing in 79% of C/G group was attributed to under-dosing of gentamicin. For quality measures, patients in C/G arm had more nighttime interruptions (3 vs. 1 interruptions per patient). 46% of patient in the ertapenem group had no overnight interruptions compared with 0% in C/G group. There were 2 suspected wound infections in the C/G group, but none in ertapenem group.ConclusionNo difference in efficacy was seen between ertapenem and C/G for treatment of postpartum endometritis Ertapenem was associated with less inappropriate dosing and fewer nighttime interruptions Improvement in patient experience and reduction of nursing workload may outweigh the small additional cost of ertapenem.Disclosures All authors: No reported disclosures.