A randomized, double-blind, placebo-controlled trial of oral antibiotic therapy following intravenous antibiotic therapy for postpartum endometritis

Article Abstract:

Endometritis is the inflammation of the endometrium, the mucous membrane lining the inner surface of the uterus. This disorder is a common complication of delivery and occurs in 20 percent of women who undergo cesarean section and one percent of women who deliver vaginally. This inflammation is a consequence of infection that is usually caused by any of several types of microorganisms, including Escherichia coli, Streptococcus agalactiae, genital mycoplasmas, and anaerobes, which are microbes that can live and grow without oxygen. Endometritis can be treated by the administration of antibiotics intravenously in the hospital setting followed by oral antibiotics after hospital discharge. However, treatment with oral antibiotics after successful therapy with intravenous (IV) antibiotics may be unnecessary and may even cause adverse side effects. The effectiveness of oral antibiotics following successful IV antibiotic treatment of endometritis after childbirth in preventing recurrence was assessed. Patient compliance with the drug regimen was also examined. The study included 136 patients with endometritis, who received either the oral antibiotic amoxicillin or a placebo (a substance with no therapeutic effect) after successful treatment with IV antibiotics. There were no cases of recurrent endometritis, wound infections, or recurrent fever. Minor side effects developed in 10 percent of patients treated with oral amoxicillin and 14 percent of patients given a placebo. Treatment was completed in 52 percent of amoxicillin-treated patients and 65 percent of patients given a placebo, suggesting only fair compliance. These findings suggest that oral antibiotic treatment is unnecessary following successful IV antibiotic therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Dosage and administration, Amoxicillin, Endometritis

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A randomized, blinded, placebo-controlled trial of antibiotics in idiopathic preterm labor

Article Abstract:

Preterm births, which occur before the 34th week of pregnancy, are associated with poor fetal outcome. Evidence is mounting implicating infection as a major cause of preterm birth. Infection can cause premature rupture of the membranes surrounding the fetus and the release of prostaglandins, hormone-like substances involved in the onset of labor. The use of antibiotic therapy to prevent maternal infection has been suggested in pregnancies complicated by preterm labor. The effect of antibiotic treatments, given in conjunction with conventional therapy aimed at reducing preterm labor, was studied. The onset of labor was defined as three contractions within a 20 minute period with cervical dilation of one centimeter or more. There were 103 patients with intact fetal membranes who were experiencing early labor without known cause. The women were assigned to receive either intravenous (IV) ampicillin plus oral erythromycin (48 women) or a placebo drug (47 women). Preterm births occurred in 38 percent of the patients receiving the placebo and 44 percent receiving antibiotics. Both groups had similar times until delivery, birth weights, and episodes of recurrent preterm labor. Adjunctive antibiotic therapy combined with standard therapy to prevent preterm delivery offered no additional benefit. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Premature labor

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Prevalence of asymptomatic hepatitis B infection in pregnant Mexican-American women

Article Abstract:

Asymptomatic hepatitis B virus is no longer a rare occurrence among pregnant women. Recent reports have documented a high risk of asymptomatic hepatitis B virus infection for Hispanic women of Caribbean and Latin American origin. Currently, the Centers for Disease Control (CDC) recommend routine screening of all pregnant women for the presence of hepatitis B virus at an early prenatal visit. A study was conducted to test the hypothesis that pregnant and asymptomatic Mexican-American women are much less frequently infected with hepatitis B virus than Hispanic women of Caribbean and South American origin, and that most of those who are carriers belong to a high-risk group. All pregnant women (3,789) were tested for hepatitis B surface antigen at the time of admission for delivery. Seventy-seven percent of the patients had Hispanic surnames. There was a significantly higher prevalence, 7.0 per 1,000 asymptomatic infections, in patients with non-Hispanic surnames than among patients with Hispanic surnames, at 2.0 per 1,000. In the total population studied, the prevalence was 3.2 per 1,000. Hepatitis B virus infection is an uncommon finding in pregnant Mexican-American women; however, routine screening is considered justified even in the absence of identifiable risk factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Demographic aspects, Hepatitis B, Pregnancy, Mexican American women, Hematologic diseases, Blood diseases in pregnancy

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