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Cesarean wound infection — USMLE Step 3 MCQ

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HardSurgeryCesarean wound infectionUSMLE Step 3

A woman develops fever, uterine tenderness, and foul lochia 36 hours after cesarean delivery. Urinalysis and chest examination are unrevealing. What is the best initial treatment?

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Correct answer: B — Give IV clindamycin plus gentamicin until afebrile for 24–48 hours

The best answer is “Give IV clindamycin plus gentamicin until afebrile for 24–48 hours”. Postcesarean polymicrobial endometritis requires broad-spectrum IV therapy covering anaerobes and gram-negative organisms. Persistent fever prompts evaluation for abscess, retained products, or septic pelvic thrombophlebitis. Postcesarean endometritis is treated with broad-spectrum IV therapy, commonly clindamycin plus gentamicin.

Reference: NCBI Bookshelf: Postpartum Infection: https://www.ncbi.nlm.nih.gov/books/NBK560804/