[Evaluation of the clinical effect and tissue distribution of piperacillin in the field of obstetrics and gynecology]

Piperacillin (PIPC) was administered to patients with obstetrical and gynecological infectious diseases and we studied its clinical effect and tissue distribution. 1. Clinical results. PIPC was administered to 26 patients at a dose of 2--4 g per day (twice a day) by dripping infusion over a period of 3--10 days (total 8--30 g). These included 16 cases with intrauterine infection, 1 with adnexitis, 4 with pelvic inflammatory disease and 5 with infections of the external genitalia. The clinical results were excellent in 11 cases, good in 13 cases and poor in 2 cases so that the overall efficacy rate was 92.3%. For bacteriological study 33 strains were isolated from 20 patients. These included Gram positive bacteria (6 strains), Gram negative bacteria (23 strains) and anaerobes (4 strains). After PIPC treatment 32 strains (including S. epidermidis 4 strains, E. coli 12 strains, K. pneumoniae 3 strains, E. aerogenes 2 strains, P. aeruginosa 2 strains and anaerobes 4 strains, etc.) disappeared except for 1 strain of K. pneumoniae which persisted. The disappearance rate was 97.0%. The only side effect observed was a slight case of malaise during the first administration day, however the relationship between the appearance of this symptom and the drug was unclear. No adverse reaction in laboratory findings was observed. 2. Tissue distribution. We determined the tissue concentration from 90 to 240 minutes after dripping infusion for 1 hour at a dose of 2 g. PIPC concentrations in these tissues including the endometrium, myometrium, cervix uteri, portio vaginalis, oviduct and ovary showed the highest level (18.0--11.7 micrograms/g) at 90 minutes after the beginning of administration. These values were 48.6--31.6% in respect to the uterine arterial blood level (37 micrograms/ml at 90 minutes after infusion).