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Intravaginal clindamycin treatment for bacterial vaginosis: effects on preterm delivery and low birth weight.
Am J Obstet Gynecol. 1995 Nov; 173(5):1527-31.AJ

Abstract

OBJECTIVE

Our goal was to evaluate whether treatment of bacterial vaginosis during pregnancy with 2% clindamycin vaginal cream reduces the incidence of either preterm delivery or low birth weight or of both.

STUDY DESIGN

A multicenter, double-blind, randomized, placebo-controlled trial in Indonesia compared a 2% clindamycin vaginal cream with a placebo cream. Women seeking prenatal care at 14 to 26 weeks of gestational age who had bacterial vaginosis (Gram stain score > 6 and pH of vaginal fluid > 4.5) were invited to participate. Of the 745 women enrolled, 681 (91.4%) women were followed up through delivery.

RESULTS

Clindamycin vaginal cream was an effective treatment for bacterial vaginosis. Two weeks after completion of the treatment, 85.5% of the women were cured. The rate of preterm delivery (< 37 weeks) was 15.0% for clindamycin patients and 13.5% for placebo patients (odds ratio 1.1, 95% confidence interval 0.7 to 1.7). The rate of low birth weight was 9.0% for clindamycin patients and 6.8% for placebo patients (odds ratio 1.3, 95% confidence interval 0.8 to 2.4).

CONCLUSIONS

Treatment of bacterial vaginosis with clindamycin vaginal cream did not reduce preterm delivery or low birth weight. Although clindamycin vaginal cream is an effective treatment for bacterial vaginosis, intravaginal treatment would not be effective against bacterial vaginosis-associated microorganisms harbored in the upper genital tract. Systemic treatment may be required to eradicate upper tract infection to reduce preterm delivery.

Authors+Show Affiliations

Division of Sexually Transmitted Diseases/Human Immunodeficiency Virus Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

7503196

Citation

Joesoef, M R., et al. "Intravaginal Clindamycin Treatment for Bacterial Vaginosis: Effects On Preterm Delivery and Low Birth Weight." American Journal of Obstetrics and Gynecology, vol. 173, no. 5, 1995, pp. 1527-31.
Joesoef MR, Hillier SL, Wiknjosastro G, et al. Intravaginal clindamycin treatment for bacterial vaginosis: effects on preterm delivery and low birth weight. Am J Obstet Gynecol. 1995;173(5):1527-31.
Joesoef, M. R., Hillier, S. L., Wiknjosastro, G., Sumampouw, H., Linnan, M., Norojono, W., Idajadi, A., & Utomo, B. (1995). Intravaginal clindamycin treatment for bacterial vaginosis: effects on preterm delivery and low birth weight. American Journal of Obstetrics and Gynecology, 173(5), 1527-31.
Joesoef MR, et al. Intravaginal Clindamycin Treatment for Bacterial Vaginosis: Effects On Preterm Delivery and Low Birth Weight. Am J Obstet Gynecol. 1995;173(5):1527-31. PubMed PMID: 7503196.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intravaginal clindamycin treatment for bacterial vaginosis: effects on preterm delivery and low birth weight. AU - Joesoef,M R, AU - Hillier,S L, AU - Wiknjosastro,G, AU - Sumampouw,H, AU - Linnan,M, AU - Norojono,W, AU - Idajadi,A, AU - Utomo,B, PY - 1995/11/1/pubmed PY - 1995/11/1/medline PY - 1995/11/1/entrez SP - 1527 EP - 31 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 173 IS - 5 N2 - OBJECTIVE: Our goal was to evaluate whether treatment of bacterial vaginosis during pregnancy with 2% clindamycin vaginal cream reduces the incidence of either preterm delivery or low birth weight or of both. STUDY DESIGN: A multicenter, double-blind, randomized, placebo-controlled trial in Indonesia compared a 2% clindamycin vaginal cream with a placebo cream. Women seeking prenatal care at 14 to 26 weeks of gestational age who had bacterial vaginosis (Gram stain score > 6 and pH of vaginal fluid > 4.5) were invited to participate. Of the 745 women enrolled, 681 (91.4%) women were followed up through delivery. RESULTS: Clindamycin vaginal cream was an effective treatment for bacterial vaginosis. Two weeks after completion of the treatment, 85.5% of the women were cured. The rate of preterm delivery (< 37 weeks) was 15.0% for clindamycin patients and 13.5% for placebo patients (odds ratio 1.1, 95% confidence interval 0.7 to 1.7). The rate of low birth weight was 9.0% for clindamycin patients and 6.8% for placebo patients (odds ratio 1.3, 95% confidence interval 0.8 to 2.4). CONCLUSIONS: Treatment of bacterial vaginosis with clindamycin vaginal cream did not reduce preterm delivery or low birth weight. Although clindamycin vaginal cream is an effective treatment for bacterial vaginosis, intravaginal treatment would not be effective against bacterial vaginosis-associated microorganisms harbored in the upper genital tract. Systemic treatment may be required to eradicate upper tract infection to reduce preterm delivery. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/7503196/Intravaginal_clindamycin_treatment_for_bacterial_vaginosis:_effects_on_preterm_delivery_and_low_birth_weight_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9378(95)90644-4 DB - PRIME DP - Unbound Medicine ER -