Adjunctive clindamycin therapy for preterm labor: results of a double-blind, placebo-controlled trial

Article Abstract:

Preterm labor is a major cause of infant illness and mortality in the US. One factor associated with preterm labor is infection of the maternal reproductive tract. Antibiotics have therefore been prescribed for women in preterm labor, but studies of their effectiveness have varied in design, patient groups, and outcome. To address the issue, a controlled study of clindamycin (an antibiotic) was carried out using 103 women hospitalized after 34, or fewer, weeks gestation. The women were given tocolytic drugs (drugs that inhibit uterine contractions) and examined for the presence of bacteria in the genital tract. They were then randomly assigned to receive either intravenous clindamycin (53 subjects) or a saline solution, a placebo, (50 subjects) for nine doses, followed by oral medication for one week. If delivery did not occur, tocolytic treatment was continued and further episodes of preterm labor were treated according to standard guidelines. Results showed that pregnancy continued longer for the women who received clindamycin (35.3 days) than for those who received saline (25.4 days). The overall rate of preterm birth in the group was 62 percent. The prolongation of pregnancy among the women receiving clindamycin was evident, even when the effects of cervical dilatation, effacement, and gestational age were taken into account. Differences were not seen between the groups in infant birth weight, gestational age at birth, or any other neonatal outcome. Preterm premature rupture of the membranes surrounding the fetus was more likely among women infected with group B streptococcus, Chlamydia trachomatis, Trichomonas vaginalis, or Staphylococcus aureus. When patients with these infections received clindamycin, they were no more likely to have preterm premature rupture of membranes than uninfected women. The effect of clindamycin in prolonging the time to delivery was significant only for women enrolled in the study prior to 33 weeks gestation. When administered at or before 32 weeks gestation, clindamycin seemed to be safe and effective. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Premature labor

---

Comparative efficacy of clindamycin versus erythromycin in eradication of antenatal Chlamydia trachomatis

Article Abstract:

Infection with the microorganism, Chlamydia trachomatis, is the most common sexually transmitted disease among pregnant women. Although C. trachomatis infection occurs three to five times more frequently than Neisseria gonorrhoeae infection, screening for C. trachomatis infection before birth is not a routine practice. C. trachomatis infection is transmitted to 60 to 70 percent of infants of infected mothers during childbirth, and can spread to the upper female genital tract in 22 to 34 percent of infected women after childbirth. Furthermore, this infection can cause premature rupture of fetal membranes. The antibiotic erythromycin is commonly used to treat C. trachomatis infection but causes nausea and vomiting and is associated with poor patient compliance. Intravenously administered erythromycin can cause irritation of the veins. Another antibiotic, clindamycin, has been shown to be effective against C. trachomatis infection in non-pregnant patients. The effectiveness and patient tolerance of clindamycin was assessed in 126 pregnant women with C. trachomatis infection of the cervix, the opening of the uterus. The results were compared with erythromycin treatment. C. trachomatis infection was cured in 92.7 percent of women treated with clindamycin and 83.8 percent of women treated with erythromycin. The frequency of gastrointestinal side effects was greater among patients treated with erythromycin, and was similar between patients treated with clindamycin and patients who did not receive either antibiotic. Patients with side effects tended to have poor compliance; moderate to good compliance was more frequently associated with cure of infection. The infection did not recur within four weeks after cessation of treatment in cured patients. These findings suggest that clindamycin is effective and well tolerated by pregnant patients with C. trachomatis infection of the cervix. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Complications and side effects, Communicable diseases, Erythromycin, Pregnancy, Chlamydia infections, Communicable diseases in pregnancy

---

Similar abstracts:

• Abstracts: Antibiotic therapy in preterm premature rupture of membranes: a randomized, prospective, double-blind trial. Trial of labor in patients with a previous lower uterine vertical cesarean section
• Abstracts: Treatment of leiomyomata uteri with leuprolide acetate depot: a double-blind, placebo-controlled, multicenter study
• Abstracts: Subcutaneous interferon alpha in the treatment of refractory condylomata. First-void urine testing for Chlamydia trachomatis by polymerase chain reaction in asymptomatic women
• Abstracts: Design considerations for AIDS trials. Implications of an alternative approach to dose-response trials. Interferon-alpha treatment leads to accumulation of virus particles on the surface of cells persistently infected with the human immunodeficiency virus type 1
• Abstracts: Outpatient laparoscopic laser cholecystectomy. Complications of laparoscopic cholecystectomy. Simple elective cholecystectomy: to drain or not

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.