Adjunctive clindamycin therapy for preterm labor: Results of a double-blind, placebo-controlled trial

McGregor, James A.; French, Janice I.; Seo, Kap-Ho

doi:10.1016/0002-9378(91)90430-y

Cited by 98 publications

(50 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Bacterial vaginosis has been correlated with premature labour (38), although the studies of the efficacy of treatment in prolonging gestation are contradictory. In a randomized study of 103 pregnant women with bacterial vaginosis and premature labour, clindamycin was more effective than placebo in prolonging gestation (36 days versus 19 days), with a nonsignificant increase in birth weight (39). In Indonesia a larger study of intravaginal gel, however, was unable to demonstrate any effect on rates of premature labour or low birth weight babies among 681 women treated in midtrimester (40).…”

Section: Gynecological Infectionsmentioning

confidence: 93%

Current Indications for the Use of Clindamycin: A Critical Review

Śmieja

1998

Canadian Journal of Infectious Diseases and Medical Microbiolog

112

View full text Add to dashboard Cite

OBJECTIVES:To review the literature and develop evidence-based guidelines for the use of the antibiotic clindamycin. DATA SOURCES: A search of the MEDLINE database for randomized clinical trials, cohort studies and review articles that examine the therapeutic use or potential adverse effects of clindamycin was undertaken for the years 1966 to 1996. In addition, relevant citations obtained from the references cited in the identified reviews, book chapters and antibiotic guidelines were included. DATA EXTRACTION: Selected articles examining the indications for or adverse effects from the prophylactic or therapeutic use of clindamycin were selected. A level of evidence was assigned to the indication according to published criteria. DATA SYNTHESIS AND CONCLUSIONS: Randomized clinical trials (level 1 evidence) support the use of clindamycin in a number of common conditions, including preoperative prophylaxis, intra-abdominal infections, recurrent group A streptococcal pharyngitis, Chlamydia trachomatis cervicitis and anaerobic lung infections. Cohort studies (level 2 evidence) support the use of clindamycin for bone and soft tissue infections. Expert opinion (level 3 evidence) supports the use of clindamycin for invasive group A streptococcal infection and the treatment of diabetic foot infections. Clindamycin's disadvantages are its high cost, the common occurrence of rash and the predisposition of patients taking clindamycin to Clostridium difficile-associated colitis. Based on cohort studies, the risk of severe diarrhea in out-patients is as low as one per 1000, but the risk of in-patients acquiring C difficile colonization may be as high as 30%.

show abstract

Section: Gynecological Infectionsmentioning

confidence: 93%

Current Indications for the Use of Clindamycin: A Critical Review

Śmieja

1998

Canadian Journal of Infectious Diseases and Medical Microbiolog

112

View full text Add to dashboard Cite

show abstract

“…Even though the causative microorganisms are manifold, the three diseases most frequently associated with vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis (3). The complications of bacterial vaginosis can be especially substantial in pregnant women, increasing the risk of an adverse pregnancy outcome, including histological chorioamnionitis (5), amniotic fluid infection (12), preterm labor, and preterm delivery (8,9). Laboratory methods for the identification of bacterial vaginosis include wet mount, Gram stain, the "gold standard" of diagnosis, and microbiological culture.…”

mentioning

confidence: 99%

DNA Hybridization Test: Rapid Diagnostic Tool for Excluding Bacterial Vaginosis in Pregnant Women with Symptoms Suggestive of Infection

et al. 2002

View full text Add to dashboard Cite

This prospective comparative study evaluated a DNA hybridization test (Affirm VPIII) as an alternative to Gram stain for the diagnosis of bacterial vaginosis. We examined vaginal smears from 1,725 pregnant women between the 12th and 36th weeks of gestation with clinical signs of vaginal infection. The DNA hybridization test compared well with Gram stain and can be used as a rapid diagnostic tool to exclude bacterial vaginosis.Common reproductive tract infections and associated inflammatory responses are the most frequent gynecological complaints, representing a central problem in modern clinical care. Vaginitis is usually characterized by vaginal discharge, vulvar itching and irritation, or odor. Even though the causative microorganisms are manifold, the three diseases most frequently associated with vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis (3). The complications of bacterial vaginosis can be especially substantial in pregnant women, increasing the risk of an adverse pregnancy outcome, including histological chorioamnionitis (5), amniotic fluid infection (12), preterm labor, and preterm delivery (8, 9). Laboratory methods for the identification of bacterial vaginosis include wet mount, Gram stain, the "gold standard" of diagnosis, and microbiological culture. Because microscopic evaluation by wet mount or Gram stain requires special diagnostic skills not available to all practitioners, overdiagnosis is common and therapy is frequently empirical. Although cultures for Gardnerella vaginalis constitute a highly sensitive method, they are not recommended for the diagnosis of bacterial vaginosis due to the high number of women positive for G. vaginalis who do not have clinical symptoms of bacterial vaginosis (2, 6). Furthermore, determination of G. vaginalis by culture is rarely useful because of the relatively long period between the examination and the time the results are finally available. Because the different forms of vaginitis call for different treatment regimens, there is a need for a rapid and highly selective tool to help the care provider diagnose bacterial vaginosis and distinguish it from other types of infection. The aim of this study was to evaluate a DNA hybridization test (Affirm VPIII) as an alternative to Gram-stained microscopic slides, currently considered the most reliable diagnostic tool.This study on the prospective comparison of two diagnostic tools included 1,725 pregnant women between the 12th and 36th weeks of gestation attending the outpatient clinic of the Department of Obstetrics and Gynecology at the University of Vienna, Vienna, Austria. If clinical symptoms such as increased vaginal discharge combined with pruritus and/or burning, cervical incompetence, lower abdominal pain, preterm labor, or preterm rupture of the membranes were present, two vaginal specimens were obtained with the Affirm VPIII sample collection set on Dacron tipped swabs for both Gram stain and nucleic acid hybridization. The samples were immediately transported to the labora...

show abstract

“…[521][522][523][524][525][526][527][528][529][530][531] Further details of the review can be found in Appendix 6, Table 131. No additional RCTs were found when the searches were updated.…”

Section: Prophylactic Antibiotics In Women With Intact Membranesmentioning

confidence: 99%

Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling

2010

Clinical Governance: An International Journal

View full text Add to dashboard Cite

How to obtain copies of this and other HTA programme reports An electronic version of this publication, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable CD-ROM is also available (see below).Printed copies of HTA monographs cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our Despatch Agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in t...

show abstract

Adjunctive clindamycin therapy for preterm labor: Results of a double-blind, placebo-controlled trial

Cited by 98 publications

References 16 publications

Current Indications for the Use of Clindamycin: A Critical Review

Current Indications for the Use of Clindamycin: A Critical Review

DNA Hybridization Test: Rapid Diagnostic Tool for Excluding Bacterial Vaginosis in Pregnant Women with Symptoms Suggestive of Infection

Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling

Contact Info

Product

Resources

About