Treatment with 2% clindamycin vaginal cream prior to first trimester surgical abortion to reduce signs of postoperative infection: A prospective, double‐blinded, placebo‐controlled, multicenter study

Larsson, Per‐Göran; Platz-Christensen, Jens-Jörgen; Dalaker, Knut; Eriksson, Katarina; Fåhraeus, Lars; Irminger, Kristine; Jerve, F; Stray‐Pedersen, Babill; Wølner‐Hanssen, Pål

doi:10.1034/j.1600-0412.2000.079005390.x

Cited by 42 publications

(38 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While these two states are found in otherwise healthy asymptomatic women, they are often associated with high Nugent scores [123], a Gram stain method used in the diagnosis of bacterial vaginosis in research settings [61,71,124-126]. High Nugent scores or changes in the vaginal microbiota have been associated with increased risk of sexually transmitted infections [20,127-138], including HIV [10,14,22,99,139-150], preterm birth [62,108,151-203], and adverse perinatal outcomes such as post-abortal sepsis [204], early and late miscarriage [165,205,206], recurrent abortion [205], histological chorioamnionitis [160,164] and postpartum endometritis [183,207]. …”

Section: Introductionmentioning

confidence: 99%

The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

et al. 2014

View full text Add to dashboard Cite

BackgroundThis study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term.ResultsA retrospective case–control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted using pyrosequencing to characterize the structure and stability of the vaginal microbiota. Linear mixed effects models and generalized estimating equations were used to identify the phylotypes whose relative abundance was different between the two study groups. The vaginal microbiota of normal pregnant women was different from that of non-pregnant women (higher abundance of Lactobacillus vaginalis, L. crispatus, L. gasseri and L. jensenii and lower abundance of 22 other phylotypes in pregnant women). Bacterial community state type (CST) IV-B or CST IV-A characterized by high relative abundance of species of genus Atopobium as well as the presence of Prevotella, Sneathia, Gardnerella, Ruminococcaceae, Parvimonas, Mobiluncus and other taxa previously shown to be associated with bacterial vaginosis were less frequent in normal pregnancy. The stability of the vaginal microbiota of pregnant women was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp.ConclusionWe report the first longitudinal study of the vaginal microbiota in normal pregnancy. Differences in the composition and stability of the microbial community between pregnant and non-pregnant women were observed. Lactobacillus spp. were the predominant members of the microbial community in normal pregnancy. These results can serve as the basis to study the relationship between the vaginal microbiome and adverse pregnancy outcomes.

show abstract

Section: Introductionmentioning

confidence: 99%

The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

et al. 2014

View full text Add to dashboard Cite

show abstract

“…This oversight is surprising considering the association of anaerobic vaginal microbiota and post-delivery pathologies such as postpartum endometritis2425 and sepsis26. Culture based methods have shown early postpartum endometritis is typically characterised by the presence of multiple microbiota often associated with bacterial vaginosis including Gardnerella vaginalis , Peptococcus spp., Bacteroides spp., Staphylococcus epidermidis , Streptococcus agalactiae and Ureaplasma urealyticum 27.…”

mentioning

confidence: 99%

The vaginal microbiome during pregnancy and the postpartum period in a European population

MacIntyre

Chandiramani

Lee

et al. 2015

Sci Rep

453

429

View full text Add to dashboard Cite

The composition and structure of the pregnancy vaginal microbiome may influence susceptibility to adverse pregnancy outcomes. Studies on the pregnant vaginal microbiome have largely been limited to Northern American populations. Using MiSeq sequencing of 16S rRNA gene amplicons, we characterised the vaginal microbiota of a mixed British cohort of women (n = 42) who experienced uncomplicated term delivery and who were sampled longitudinally throughout pregnancy (8–12, 20–22, 28–30 and 34–36 weeks gestation) and 6 weeks postpartum. We show that vaginal microbiome composition dramatically changes postpartum to become less Lactobacillus spp. dominant with increased alpha-diversity irrespective of the community structure during pregnancy and independent of ethnicity. While the pregnancy vaginal microbiome was characteristically dominated by Lactobacillus spp. and low alpha-diversity, unlike Northern American populations, a significant number of pregnant women this British population had a L. jensenii-dominated microbiome characterised by low alpha-diversity. L. jensenii was predominantly observed in women of Asian and Caucasian ethnicity whereas L. gasseri was absent in samples from Black women. This study reveals new insights into biogeographical and ethnic effects upon the pregnancy and postpartum vaginal microbiome and has important implications for future studies exploring relationships between the vaginal microbiome, host health and pregnancy outcomes.

show abstract

“…Clindamycin is frequently used in the treatment of BV in nonpregnant women [4][5][6][7][8][9][10][11] . The goal of effective BV treatment is not only inhibition of G. vaginalis and anaerobe growth, but also avoidance of a negative impact on the growth of Lactobacillus spp.…”

mentioning

confidence: 99%

The Inhibitory Effect of Clindamycin on Lactobacillus in vitro

Aroutcheva

Simões

Shott

et al. 2001

Infectious Diseases in Obstetrics and Gynecology

View full text Add to dashboard Cite

Objective: To evaluate the in vitro effect of varying concentrations of clindamycin on Lactobacillus spp. Methods: Concentrations of clindamycin ranging from 1.95-20 000 mg/ml were studied for their effect on the growth of six strains of Lactobacillus. Results: Clindamycin concentrations between 1.95-31.25 mg/ml had no statistically significant effect on growth of lactobacilli (p > 0.05). Concentrations 125 and 250 mg/ml had a bacteriostatic effect. The mean minimum inhibitory concentration (MIC) for studied Lactobacillus strains was determined as 1000 mg/ml. Conclusion: High concentrations of clindamycin achieved in the vagina by intravaginal application might be inhibitory for Lactobacillus.

show abstract

Treatment with 2% clindamycin vaginal cream prior to first trimester surgical abortion to reduce signs of postoperative infection: A prospective, double‐blinded, placebo‐controlled, multicenter study

Abstract: Preoperative treatment for at least three days with clindamycin cream significantly reduced the risk for developing signs of post-abortion infection only among women with preoperative abnormal vaginal flora (BV and intermediate flora).

Cited by 42 publications

References 17 publications

The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

The vaginal microbiome during pregnancy and the postpartum period in a European population

The Inhibitory Effect of Clindamycin on Lactobacillus in vitro

Contact Info

Product

Resources

About