Prophylactic antibiotics for suction curettage abortion: Results of a clinical controlled trial

Levallois, Patrick; Rioux, Jacques-E.

doi:10.1016/0002-9378(88)90787-9

Cited by 51 publications

(27 citation statements)

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“…Treatment with antibiotic drugs has been recommended for women as prophylaxis against PID after legal first trimester abortion (Heisterberg et al 1985; Levallois & Rioux 1988; Larsson et al 1992; Sørensen et al 1992). In the present randomised controlled trial, we investigated the efficacy of prophylaxis with a single dose of a third generation cephalosporin, ceftriaxone (Rocephalin®).…”

Section: Discussionmentioning

confidence: 99%

“…The reported frequency of post‐operative pelvic inflammatory disease (PID) is 3 to 20% (Moberg et al 1978; Westergaard et al 1982; Heisterberg et al 1985; Barbacci et al 1986; Giertz et al 1987; Heisterberg & Kringelbach 1987; Levallois & Rioux 1988; Prien‐Larsen & Kjer 1989; Larsson et al 1992; Sørensen et al 1992) and is influenced by the microbial flora of the vagina and cervix. In particular, the presence in the cervix of Chlamydia trachomatis increases the risk of postabortal inflammation (Moberg et al 1978; Westergaard et al 1982; Barbacci et al 1986; Levallois & Rioux 1988; Prien‐Larsen & Kjer 1989; Larsson et al 1992; Sørensen et al 1992). Other bacterial species also may increase the risk of postabortal infection, of which Neisseria gonorrhoeae is the classic example (Heisterberg et al 1985; Prien‐Larsen & Kjer 1989).…”

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confidence: 99%

“…Prophylactic treatment with antibiotics of women at high risk of postabortal PID has been recommended. These risk factors include young age, a history of PID, a positive cervical or urethral culture of C. trachomatis or N. gonorrhoeae , and bacterial vaginosis (Moberg et al 1978; Heisterberg et al 1985; Levallois & Rioux 1988; Larsson et al 1992; Sørensen et al 1992). However, the value of prophylaxis in women without risk factors is less clear.…”

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A randomised controlled trial of prophylaxis of post‐abortal infection: ceftriaxone versus placebo

Henriques

Wilken‐Jensen

Thorsen

et al. 1994

BJOG

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Objective To investigate the incidence of post‐operative infection after first trimester abortion in women treated with a long‐acting cephalosporin (ceftriaxone) compared with low risk patients receiving no treatment and with high risk patients receiving our standard treatment of ampicillin/pivampicillin and metronidazole. Design A prospective, randomised controlled trial. Setting Department of Obstetrics and Gynaecology, Rigshospitalet, University of Copenhagen, Denmark. Subjects Nine hundred and ninety‐six women, admitted on an outpatient basis for legal termination of pregnancy at 12 weeks or less of gestation, were included in the study after giving informed consent. The women were divided into high risk and low risk categories and allocated either to treatment with ceftriaxone or to standard treatment. For high risk patients the standard treatment was initiated by a peroperative injection of ampicillin and metronidazole, followed by oral doses of metronidazole and pivampicillin three times daily for four days. No prophylactic antibiotics were given to the women randomised to standard treatment in the low risk group. Interventions All women were kept under observation, and, between six and 14 days post‐operatively, underwent pelvic examination. Clinical endpoints were noted. Main outcome measures Post‐operative pelvic inflammatory disease in women applying for legal first trimester abortion. Results Seven hundred and eighty‐six women fulfilled the criteria for evaluation. A tendency toward a prophylactic effect of ceftriaxone was observed in most clinical findings. A significant prophylactic effect of ceftriaxone was found in the low risk group. Conclusions This study demonstrated a significant reduction in post‐operative pelvic inflammatory disease in low risk patients, who were applying for legal first trimester abortion, treated peroperatively with ceftriaxone. No significant difference was demonstrated between high risk patients treated with ceftriaxone or ampicillin/pivampicillin and metronidazole.

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Section: Discussionmentioning

confidence: 99%

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A randomised controlled trial of prophylaxis of post‐abortal infection: ceftriaxone versus placebo

Henriques

Wilken‐Jensen

Thorsen

et al. 1994

BJOG

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“…5 In a much larger series of 170,000 first-trimester outpatient abortions in New York City from 1971 to 1987, sepsis requiring hospitalization (defined as a temperature of 40°C or higher for 2 or more days) was recorded in only 36 women (0.021%). Apart from pelvic inflammatory disease and/or endometritis, which complicates between 29% and 40% of induced abortions in women harboring Neisseria gonorrhoeae or Chlamydia trachomatis and approximately 3% of procedures in women who do not, 5,6 serious infectious complications of D&C are rare.…”

Section: Yansouni Bacterial Sacroiliitis and Gluteal Abscess Obstetmentioning

confidence: 99%

Bacterial Sacroiliitis and Gluteal Abscess After Dilation and Curettage for Incomplete Abortion

Yansouni

Ponette²,

Rouleau³

2009

Obstetrics &Amp; Gynecology

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“…1982; Osser & Persson 1984; Møller et al . 1982; Heisterberg 1987; Levallois & Rioux 1988; Osser & Persson 1989).…”

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A double‐blind randomized study of the effect of erythromycin in preventing pelvic inflammatory disease after first trimester abortion

Sørensen¹,

Thranov²,

Hoff³

et al. 1992

BJOG

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Objective To assess the prophylactic use of erythromycin in prevention of post‐abortal pelvic inflammation disease (PID) in first trimester abortion. Design Double‐blind, randomized controlled trial. Setting Department of Surgery, County Hospital, Denmark. Subjects Four hundred and thirty two women who were to undergo induced abortion before 12 weeks gestation were randomized to be treated either with prophylactic erythromycin or a placebo. Intervention The women were randomized to receive a placebo or erythromycin, 500 mg twice a day for 71/2 days starting the evening before the abortion. All the women were investigated for Chlamydia trachomatis and Neisseria gonorrhoea before the abortion. Main outcome measures Frequency of cervical C. trachomatis and N. gonorrhoea and frequency of PID after abortion. Results Fifty four women were excluded after randomization. The frequency of PID was 11% (20/189) in the erythromycin group and 16% (30/189) in the placebo group (P= 0.13, χ2‐test). The prevalence of C. trachomatis was 19% (15/78) in women ≤ 20 years of age, 13% (14/109) in women between 21 and 25 years and 2% (5/241) in women ≤ 26 years of age. In women positive for C. trachomatis erythromycin prophylaxis significantly reduced the frequency of PID to 8% (l/13) compared with 43% (6/14) in the placebo group (P= 0.051, logistic regression analysis). Erythromycin had no effect on other potential high risk groups (first pregnancy, nulliparous, <20 years of age, and women with previous PID). Conclusion Prophylactic erythromycin is not warranted for all women having an abortion. Cervical C. trachomatis is a risk factor for postabortal PID, and prophylaxis with erythromycin significantly reduces the frequency of PID. However, only a few women with PID had cervical C. trachomatis, and the prevention of post‐abortal PID remains a major challenge requiring further studies.

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Prophylactic antibiotics for suction curettage abortion: Results of a clinical controlled trial

Cited by 51 publications

References 10 publications

A randomised controlled trial of prophylaxis of post‐abortal infection: ceftriaxone versus placebo

A randomised controlled trial of prophylaxis of post‐abortal infection: ceftriaxone versus placebo

Bacterial Sacroiliitis and Gluteal Abscess After Dilation and Curettage for Incomplete Abortion

A double‐blind randomized study of the effect of erythromycin in preventing pelvic inflammatory disease after first trimester abortion

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