A randomized placebo-controlled trial of erythromycin for the treatment of Ureaplasma urealyticum to prevent premature delivery

Eschenbach, David A.; Nugent, Robert P.; Rao, Adupa P.; Cotch, Mary Frances; Gibbs, Ronald S.; Lipscomb, Kathleen A.; Martín, David H.; Pastorek, Joseph G.; Rettig, Philip J.; Carey, J. Christopher; Regan, Joan A.; Geromanos, Kim L.; Lee, Molly L.F.; Poole, W. Kenneth; Edelman, Robert

doi:10.1016/0002-9378(91)90506-m

Cited by 157 publications

(38 citation statements)

References 14 publications

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“…Details of inclusion and exclusion criteria have been published previously. 12,13 Research personnel obtained demographic, obstetric, sexual, contraceptive, and drug use history on standardized coded forms; performed a standardized physical and pelvic examination; and collected urogenital cultures in a standard manner. At delivery the medical records of the mother and infants were reviewed and information on intervening therapy, including non-trial antibiotic use, was abstracted.…”

Section: Subjects and Methods Study Designmentioning

confidence: 99%

Double-blind placebo-controlled treatment trial ofChlamydia trachomatis endocervical infections in pregnant women

Martín

Eschenbach

Cotch

et al. 1997

Infect. Dis. Obstet. Gynecol.

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Objective: The purpose of this study was to determine if treatment of pregnant women with Chlamydia trachomatis infection would lower the incidence of preterm delivery and/or low birth weight.Methods: Pregnant women between the 23rd and 29th weeks of gestation were randomized in double-blind fashion to receive either erythromycin 333 mg three times daily or an identical placebo.The trial continued until the end of the 35th week of gestation.Results: When the results were examined without regard to study site, erythromycin had little impact on reducing low birth weight (8% vs. 11%, P 0.4) or preterm delivery (13% vs. 15%, P 0.7). At the sites with high persistence of C. trachomatis in the placebo-treated women, low birth weight infants occurred in 9 (8%) of 114 erythromycin-treated and 18 (17%) of 105 placebo-treated women (P 0.04) and delivery <37 weeks occurred in 15 (13%) of 115 erythromycin-treated and 18 (17%) of 105 placebo-treated women (P 0.4).Conclusions: The results of this trial suggest that the risk of low birth weight can be decreased by giving erythromycin to some women with C. trachomatis. Due to the high clearance rate of C.

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Section: Subjects and Methods Study Designmentioning

confidence: 99%

Double-blind placebo-controlled treatment trial ofChlamydia trachomatis endocervical infections in pregnant women

Martín

Eschenbach

Cotch

et al. 1997

Infect. Dis. Obstet. Gynecol.

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“…This is probably at the heart of why antimicrobial treatment to prevent preterm birth has largely failed. Patients with Group B streptococcus (GBS) or Ureaplasma urealyticum [390] are not at risk for preterm delivery, and therefore, treatment of colonized women has not reduced the rate of preterm birth. The same applies to patients with asymptomatic Trichomonas vaginalis [391].…”

Section: Aetiologies Of the Preterm Parturition Syndromementioning

confidence: 99%

The preterm parturition syndrome and its implications for understanding the biology, risk assessment, diagnosis, treatment and prevention of preterm birth

Gotsch

Romero²,

Erez

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

117

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“…80 Furthermore, antibiotic treatment including tetracycline, erythromycin, and clindamycin has been shown to increase newborn weight among treated mother-infant pairs. 81 This may reflect treatment of ureaplasma urealyticum rather than bacterial vaginosis. Bacteroides has been isolated from the vaginal cultures of women who have infants weighing less than 2,500 g and who are more likely to give birth before 37 weeks' gestation.…”

Section: Bacterial Vaginosis Pathologymentioning

confidence: 99%

Evaluation and management of vaginitis

1998

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V aginitis is a common medical problem in women that is associated with substantial discomfort and frequent medical visits. Roughly 5 to 10 million office visits per year are attributed to vaginitis. 1 Research in recent years has increased our understanding of the disease process and its potential sequelae and resulted in improved diagnostic and treatment modalities. 2-6 Nevertheless, adequate diagnosis and treatment of vaginitis in the office setting often is problematic for practitioners. 2,5,7-9 Moreover, the availability of over-the-counter medications for fungal vaginitis has increased the likelihood that women will come to medical attention with partially or inadequately treated infections. 10 We will focus on the common infectious causes of vaginal discharge-yeast infection, bacterial vaginosis, and trichomonas infection, emphasizing new developments in diagnosis, associated complications, and treatment of these infections.The initial evaluation of vaginal discharge requires an understanding of physiologic vaginal discharge and what differentiates it from abnormal, pathologic discharge. Substances from the vulvar, sebaceous, sweat, Bartholin's and Skene's glands, as well as exfoliated cells, cervical mucus, and secretions of the endometrial cavity and fallopian tubes constitute the normal physiologic secretions of the vagina. These secretions pool in the posterior fornix and do not adhere to the vaginal walls. 11 The pH of normal vaginal secretions in women of childbearing age is between 3.8 and 4.5. The presence of sperm, blood, amniotic fluid, or cervical mucus raises the vaginal pH. 11 The amount and fluidity of the discharge can vary over the menstrual cycle. Cervical mucus becomes more fluid around ovulation, and women frequently mistake this change in consistency for an abnormal discharge. Stress increases the rate of vaginal desquamation and thus the amount of discharge, which patients can also mistake for a pathologic discharge. 12 Women generally do not have other symptoms if their discharge is physiologic.In contrast, a pathologic discharge adheres to the vaginal walls and is often accompanied by irritation, pruritus, odor, or urinary symptoms such as dysuria or frequency. 6 The discharge can be thick to watery and frothy, and white to yellow, gray, or green. 11 Causes of an abnormal discharge include infectious causes of vaginitis such as yeast infection, bacterial vaginosis, and trichomonas infection, as well as cervicitis and sexually transmitted diseases such as gonorrhea and chlamydia infection. Noninfectious etiologies include chemical irritants such

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A randomized placebo-controlled trial of erythromycin for the treatment of Ureaplasma urealyticum to prevent premature delivery

Cited by 157 publications

References 14 publications

Double-blind placebo-controlled treatment trial ofChlamydia trachomatis endocervical infections in pregnant women

Double-blind placebo-controlled treatment trial ofChlamydia trachomatis endocervical infections in pregnant women

The preterm parturition syndrome and its implications for understanding the biology, risk assessment, diagnosis, treatment and prevention of preterm birth

Evaluation and management of vaginitis

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