Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the first-line treatment for endometritis?

1. Metronidazole

2. Co-moxiclav

3. Ceftriaxone

4. Azithromycin

The correct answer is: Co-moxiclav

The first-line treatment for endometritis is co-amoxiclav. This combination antibiotic includes amoxicillin, which is effective against a broad range of bacteria, along with clavulanic acid, which inhibits beta-lactamase enzymes that some bacteria produce to resist penicillin-like antibiotics. Given that endometritis often follows obstetric procedures or infections, the coverage provided by co-amoxiclav for both aerobic and anaerobic bacteria makes it particularly effective for treating this condition. Co-amoxiclav ensures that the treatment addresses common pathogens associated with endometritis, including Streptococcus and Escherichia coli, as well as anaerobes like Bacteroides species. The comprehensive spectrum of activity is essential in the context of endometritis since the infection may involve multiple organisms. While other options include effective antibiotics, they do not provide the same broad coverage and therefore are not the first choice for this specific condition. Metronidazole is often used in combination regimens but is not typically the sole treatment for endometritis. Similarly, ceftriaxone is primarily indicated for Neisseria gonorrhoeae infections and other acute infections but lacks the anaerobic coverage that endometritis might require. Azithromycin, although effective for