Larsson P G, Platz-Christensen J J, Dalaker K, Eriksson K, Fåhraeus L, Irminger K, Jerve F, Stray-Pedersen B, Wölner-Hanssen P
Department of Obstetrics and Gynaecology at the Central Hospital of Skövde, Sweden.
Acta Obstet Gynecol Scand. 2000 May;79(5):390-6.
Bacterial vaginosis (BV) and intermediate flora is known risk-factor for postoperative infection after surgical termination of pregnancy. Vaginal application of 2% clindamycin cream is an efficacious treatment for BV, but it is not known whether preoperative administration of clindamycin cream might reduce the signs of post-abortion infection after surgical termination of pregnancy.
To evaluate whether preoperative treatment with clindamycin cream might reduce the signs of post-abortion infection after legal abortion.
Prospective, double-blinded, placebo-controlled, multicenter study.
Consecutive women attending for surgical termination prior to 11+4 gestational weeks were approached. We randomized participants to preoperative vaginal treatment with 2% clindamycin cream or placebo cream in a double-blinded fashion. At all visits vaginal smears were air dried on microscopy slides to be stored. The rate of postoperative pelvic infection according to our definition was the main outcome variable, the cure rates of BV and of intermediate flora were secondary outcome variables.
Of 1655 enrolled women, 1102 were evaluable for analyses. Fifty-eight women developed signs of post-abortion infection. Preoperative treatment with clindamycin cream significantly (RR: 4.2, 95% C.I. 1.2-15.9) reduced the risk of post-abortion infection among women with abnormal vaginal flora (BV and intermediate flora). Treatment with clindamycin cream in women with normal lactobacilli flora did not demonstrate any difference compared to the non-treatment group.
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).
细菌性阴道病（BV）和中间型菌群是人工终止妊娠术后感染的已知危险因素。阴道应用2%克林霉素乳膏是治疗BV的有效方法，但术前给予克林霉素乳膏是否能降低人工终止妊娠术后流产后感染的迹象尚不清楚。
评估术前使用克林霉素乳膏治疗是否能降低合法流产后流产后感染的迹象。
前瞻性、双盲、安慰剂对照、多中心研究。
纳入孕11⁺⁴周前前来接受人工终止妊娠的连续女性。我们以双盲方式将参与者随机分为术前阴道使用2%克林霉素乳膏或安慰剂乳膏。在每次就诊时，将阴道涂片在显微镜载玻片上晾干保存。根据我们的定义，术后盆腔感染率是主要结局变量，BV和中间型菌群的治愈率是次要结局变量。
在1655名登记女性中，1102名可纳入分析。58名女性出现了流产后感染的迹象。术前使用克林霉素乳膏显著（RR：4.2，95%置信区间1.2 - 15.9）降低了阴道菌群异常（BV和中间型菌群）女性流产后感染的风险。在乳酸杆菌菌群正常的女性中，使用克林霉素乳膏治疗与未治疗组相比没有显示出任何差异。
术前至少三天使用克林霉素乳膏治疗仅在术前阴道菌群异常（BV和中间型菌群）的女性中显著降低了出现流产后感染迹象的风险。
