Ogasawara K K, Goodwin T M
Department of Obstetrics and Gynecology, University of Southern California, School of Medicine, Women's and Children's Hospital, Los Angeles, USA.
J Matern Fetal Med. 1999 Jan-Feb;8(1):12-6. doi: 10.1002/(SICI)1520-6661(199901/02)8:1<12::AID-MFM3>3.0.CO;2-8.
The purpose of this study was to determine if azithromycin is effective in reducing lower genital colonization of Ureaplasma urealyticum in women with preterm labor or preterm premature rupture of membranes (PROM).
A randomized, double-blinded, placebo-controlled prospective study of 60 pregnancies was carried out between 22 and 34 weeks. Genital mycoplasma cultures were performed at the time of admission. Patients were randomized to receive either a single dose of azithromycin (four 250 mg capsules) or a placebo in addition to prophylactic intravenous ampicillin. Repeat cultures were done on undelivered patients 7 days after enrollment. The study had power to detect a 50% decrease in colonization.
Overall, lower genital colonization was 47/59 (79.7%) for U. urealyticum. Seven days after enrollment, U. urealyticum was isolated in 14/15 (93.3%) of the azithromycin-treated cases and in 11/14 (78.6%) of the controls (RR = 1.19, 95% CI = 0.88-1.61). Vertical transmission of U. urealyticum was 3/15 (20%) in the azithromycin-treated cases and 5/10 (50%) for the controls (RR = 0.40, 95%, CI = 0.12-1.31).
These data suggests that a single 1 g dose of azithromycin is ineffective in reducing lower genital colonization with U. urealyticum.
本研究旨在确定阿奇霉素对降低早产或胎膜早破（PROM）女性下生殖道解脲脲原体定植是否有效。
对60例妊娠22至34周的孕妇进行了一项随机、双盲、安慰剂对照的前瞻性研究。入院时进行生殖道支原体培养。患者被随机分配接受单剂量阿奇霉素（四粒250毫克胶囊）或安慰剂，此外还接受预防性静脉注射氨苄青霉素。对未分娩的患者在入组7天后进行重复培养。该研究有能力检测到定植减少50%。
总体而言，解脲脲原体在下生殖道的定植率为47/59（79.7%）。入组7天后，阿奇霉素治疗组14/15（93.3%）分离出解脲脲原体，对照组11/14（78.6%）分离出解脲脲原体（相对危险度=1.19，95%可信区间=0.88 - 1.61）。阿奇霉素治疗组解脲脲原体垂直传播率为3/15（20%），对照组为5/10（50%）（相对危险度=0.40，95%可信区间=0.12 - 1.31）。
这些数据表明，单剂量1克阿奇霉素在降低下生殖道解脲脲原体定植方面无效。
