Chlamydia trachomatis may also be a pathogen. Complete blood count reveals leukocytosis with a left shift. Anemia is a risk factor for the development of endometritis. The role of endocervical cultures is controversial. They generally are not helpful in management.
Urine cultures help rule out urinary tract infection.
Prophylactic antibiotics significantly decrease incidence of postpartum endometritis, and are indicated for cesarean deliveries. The gold standard treatment is gentamicin and clindamycin. Recently, a trend towards use of broad-spectrum monotherapy has emerged. Cephalosporins, extended-spectrum penicillins, and fluoroquinolones are used as monotherapy. Treat patients with the same regimen for at least 48-72 hours to determine clinical efficacy.