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Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis.
N Engl J Med. 1995 Dec 28; 333(26):1732-6.NEJM

Abstract

BACKGROUND

Pregnant women with bacterial vaginosis may be at increased risk for preterm delivery. We investigated whether treatment with metronidazole and erythromycin during the second trimester would lower the incidence of delivery before 37 weeks' gestation.

METHODS

In 624 pregnant women at risk for delivering prematurely, vaginal and cervical cultures and other laboratory tests for bacterial vaginosis were performed at a mean of 22.9 weeks' gestation. We then performed a 2:1 double-blind randomization to treatment with metronidazole and erythromycin (433 women) or placebo (191 women). After treatment, the vaginal and cervical tests were repeated and a second course of treatment was given to women who had bacterial vaginosis at that time (a mean of 27.6 weeks' gestation).

RESULTS

A total of 178 women (29 percent) delivered infants at less than 37 weeks' gestation. Eight women were lost to follow-up. In the remaining population, 110 of the 426 women assigned to metronidazole and erythromycin (26 percent) delivered prematurely, as compared with 68 of the 190 assigned to placebo (36 percent, P = 0.01). However, the association between the study treatment and lower rates of prematurity was observed only among the 258 women who had bacterial vaginosis (rate of preterm delivery, 31 percent with treatment vs. 49 percent with placebo; P = 0.006). Of the 358 women who did not have bacterial vaginosis when initially examined, 22 percent of those assigned to metronidazole and erythromycin and 25 percent of those assigned to placebo delivered prematurely (P = 0.55). The lower rate of preterm delivery among the women with bacterial vaginosis who were assigned to the study treatment was observed both in women at risk because of previous preterm delivery (preterm delivery in the treatment group, 39 percent; and in the placebo group, 57 percent; P = 0.02) and in women who weighed less than 50 kg before pregnancy (preterm delivery in the treatment group, 14 percent; and in the placebo group, 33 percent; P = 0.04).

CONCLUSIONS

Treatment with metronidazole and erythromycin reduced rates of premature delivery in women with bacterial vaginosis and an increased risk for preterm delivery.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Alabama at Birmingham 35233-7333, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

7491136

Citation

Hauth, J C., et al. "Reduced Incidence of Preterm Delivery With Metronidazole and Erythromycin in Women With Bacterial Vaginosis." The New England Journal of Medicine, vol. 333, no. 26, 1995, pp. 1732-6.
Hauth JC, Goldenberg RL, Andrews WW, et al. Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. N Engl J Med. 1995;333(26):1732-6.
Hauth, J. C., Goldenberg, R. L., Andrews, W. W., DuBard, M. B., & Copper, R. L. (1995). Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. The New England Journal of Medicine, 333(26), 1732-6.
Hauth JC, et al. Reduced Incidence of Preterm Delivery With Metronidazole and Erythromycin in Women With Bacterial Vaginosis. N Engl J Med. 1995 Dec 28;333(26):1732-6. PubMed PMID: 7491136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. AU - Hauth,J C, AU - Goldenberg,R L, AU - Andrews,W W, AU - DuBard,M B, AU - Copper,R L, PY - 1995/12/28/pubmed PY - 1995/12/28/medline PY - 1995/12/28/entrez SP - 1732 EP - 6 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 333 IS - 26 N2 - BACKGROUND: Pregnant women with bacterial vaginosis may be at increased risk for preterm delivery. We investigated whether treatment with metronidazole and erythromycin during the second trimester would lower the incidence of delivery before 37 weeks' gestation. METHODS: In 624 pregnant women at risk for delivering prematurely, vaginal and cervical cultures and other laboratory tests for bacterial vaginosis were performed at a mean of 22.9 weeks' gestation. We then performed a 2:1 double-blind randomization to treatment with metronidazole and erythromycin (433 women) or placebo (191 women). After treatment, the vaginal and cervical tests were repeated and a second course of treatment was given to women who had bacterial vaginosis at that time (a mean of 27.6 weeks' gestation). RESULTS: A total of 178 women (29 percent) delivered infants at less than 37 weeks' gestation. Eight women were lost to follow-up. In the remaining population, 110 of the 426 women assigned to metronidazole and erythromycin (26 percent) delivered prematurely, as compared with 68 of the 190 assigned to placebo (36 percent, P = 0.01). However, the association between the study treatment and lower rates of prematurity was observed only among the 258 women who had bacterial vaginosis (rate of preterm delivery, 31 percent with treatment vs. 49 percent with placebo; P = 0.006). Of the 358 women who did not have bacterial vaginosis when initially examined, 22 percent of those assigned to metronidazole and erythromycin and 25 percent of those assigned to placebo delivered prematurely (P = 0.55). The lower rate of preterm delivery among the women with bacterial vaginosis who were assigned to the study treatment was observed both in women at risk because of previous preterm delivery (preterm delivery in the treatment group, 39 percent; and in the placebo group, 57 percent; P = 0.02) and in women who weighed less than 50 kg before pregnancy (preterm delivery in the treatment group, 14 percent; and in the placebo group, 33 percent; P = 0.04). CONCLUSIONS: Treatment with metronidazole and erythromycin reduced rates of premature delivery in women with bacterial vaginosis and an increased risk for preterm delivery. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/7491136/Reduced_incidence_of_preterm_delivery_with_metronidazole_and_erythromycin_in_women_with_bacterial_vaginosis_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM199512283332603?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -