Danti L, Ravelli V, Lojacono A, Tanzi P, Comberti E, Foresti I, Bondio M, Gastaldi A
Clinica Ostetrica e Ginecologica, Università degli Studi e Spedali Civili, Bresica.
Minerva Ginecol. 1997 May;49(5):235-40.
To evaluate the clinical and therapeutic efficacy of 2% clindamycin vaginal cream in pregnant women heavily colonized with group B streptococci (GBS).
A prospective, clinical trial in which carriers of group B streptococci were randomized to receive topical intravaginal clindamycin or oral amoxicillin.
We randomized 105 pregnant women: 55 received 2% clindamycin vaginal cream (100 mg/day for 7 days) and 50 oral amoxicillin (2 g/day for 7 days).
Patients were treated during pregnancy, none of them received intrapartum chemoprophylaxis. On the other hand, all the neonates, within 24 hours from delivery, were studied from the microbiological point of view, carrying out auricolar, nasal, oropharyngeal and umbilical cultures. RELIEFS: The eradication of the microorganism was evaluated by performing a vaginal culture after 6 weeks from the beginning of antibiotic therapy.
The eradication rate of the microorganism was significantly higher in women treated with topical clindamycin compared with the group receiving oral amoxicillin (71% versus 36%; p < 0.05). The neonatal outcome was similar in the two groups in terms of gestational age at delivery and mean birthweight. None of the neonates was admitted to the neonatal intensive care unit and no cases of neonatal sepsis were recorded.
From our experience we can conclude that, during pregnancy, a treatment with topical intravaginal clindamycin may be useful in the eradication of GBS.
评估2%克林霉素阴道乳膏对B族链球菌（GBS）高度定植的孕妇的临床及治疗效果。
一项前瞻性临床试验，将B族链球菌携带者随机分为两组，分别接受阴道局部使用克林霉素或口服阿莫西林治疗。
我们将105名孕妇随机分组：55名接受2%克林霉素阴道乳膏治疗（100毫克/天，共7天），50名口服阿莫西林（2克/天，共7天）。
患者在孕期接受治疗，均未接受产时化学预防。另一方面，所有新生儿在出生后24小时内，从微生物学角度进行研究，采集耳、鼻、口咽及脐部培养物。疗效评估：在抗生素治疗开始6周后进行阴道培养，以评估微生物的根除情况。
与口服阿莫西林组相比，局部使用克林霉素治疗的女性微生物根除率显著更高（71%对36%；p<0.05）。两组在分娩时的孕周和平均出生体重方面的新生儿结局相似。没有新生儿入住新生儿重症监护病房，也没有记录到新生儿败血症病例。
根据我们的经验可以得出结论，孕期局部阴道使用克林霉素治疗可能有助于根除GBS。
