What is the standard treatment for endometritis if antibiotic therapy fails?

In cases of endometritis where initial antibiotic therapy is unsuccessful, clindamycin is a crucial option due to its effective coverage against anaerobic bacteria, which are often involved in the infection. Clindamycin is particularly beneficial in polymicrobial infections of the uterus, such as those that may occur postpartum.

When treating endometritis, especially after delivery or surgical procedures, it is essential to consider broad-spectrum coverage. Clindamycin's ability to penetrate tissues effectively makes it an excellent choice for treating anaerobic organisms that could be contributing to the ongoing infection. Additionally, it is often combined with another antibiotic that covers aerobic bacteria for a more comprehensive approach.

While other options may have their roles in treating certain types of infections, they do not provide the same spectrum of anaerobic coverage as clindamycin, nor are they as commonly used as an alternative when first-line therapies are ineffective. Thus, clindamycin emerged as the standard supportive treatment when faced with antibiotic failure in the context of endometritis.