Joshi J V, Joshi U M, Sankholi G M, Krishna U, Mandlekar A, Chowdhury V, Hazari K, Gupta K, Sheth U K, Saxena B N
Contraception. 1980 Dec;22(6):643-52. doi: 10.1016/0010-7824(80)90089-x.
Plasma levels of norethisterone (NET), ethinyl estradiol (EE), Ampicillin or Metronidazole were estimated in 16 women, who were taking low-dose oral combination contraceptive pills (containing norethisterone acetate 1 mg and ethinyl estradiol 30 microgram) and in whom concurrently, either Ampicillin (6 women) or Metronidazole therapy (10 women) was given. Neither Ampicillin nor Metronidazole therapy altered the 'peak' or 24-hour plasma levels and area under the curve, for NET and EE. Furthermore, oral contraceptive treatment did not alter the 'peak' levels of Ampicillin or Metronidazole. Progesterone (P) levels were in the anovulatory range in all Ampicillin treated cycles. However, in Metronidazole treated group, two out of 10 women showed a P rise of more than 4 ng/ml. The study was expanded to include another group of 15 women treated with Metronidazole, where only one women showed a P rise of more than 4 ng/ml. The occurrence of 'escape ovulation' as suggested by P rise of more than 4 ng/ml in three out of 25 Metronidazole treated women is either a chance incidence due to a different pharmacological response in them, or most probably due to the default in the regular intake of pills in these women. This is supported by the observation that one out of three women showing a P rise (greater than 4 ng/ml( during concurrent Metronidazole therapy, also showed ovulatory P values in oral contraceptive-only treated cycles. Furthermore, in the control group also, one out of 10 women had ovulatory P levels (greater than 4 ng/ml) in oral contraceptive-only treated cycles.
对16名女性的血浆炔诺酮（NET）、炔雌醇（EE）、氨苄西林或甲硝唑水平进行了评估。这些女性正在服用低剂量口服复方避孕药（含醋酸炔诺酮1毫克和炔雌醇30微克），同时，其中6名女性接受了氨苄西林治疗，10名女性接受了甲硝唑治疗。氨苄西林和甲硝唑治疗均未改变NET和EE的“峰值”、24小时血浆水平及曲线下面积。此外，口服避孕药治疗也未改变氨苄西林或甲硝唑的“峰值”水平。在所有接受氨苄西林治疗的周期中，孕酮（P）水平处于无排卵范围。然而，在甲硝唑治疗组中，10名女性中有2名的P值升高超过4纳克/毫升。该研究扩展至纳入另一组15名接受甲硝唑治疗的女性，其中只有1名女性的P值升高超过4纳克/毫升。在25名接受甲硝唑治疗的女性中，有3名女性的P值升高超过4纳克/毫升，提示出现“突破性排卵”，这要么是由于她们不同的药理反应导致的偶然事件，要么很可能是由于这些女性未规律服药。这一观点得到以下观察结果的支持：在同时接受甲硝唑治疗期间P值升高（大于4纳克/毫升）的3名女性中，有1名在仅接受口服避孕药治疗的周期中也出现了排卵时的P值。此外，在对照组中，10名女性中有1名在仅接受口服避孕药治疗的周期中出现了排卵时的P水平（大于4纳克/毫升）。
