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Bacterial vaginosisFrom: Dr. Ainsworth (ainsron@sbcglobal.net)Tue Apr 12 16:52:49 2005
Antibiotic Treatment for Bacterial Vaginosis Does Not Prevent Preterm Birth NEW YORK (Reuters Health) Apr 01 - Antibiotic therapy for bacterial vaginosis or Trichomonas vaginalis during pregnancy does not cut the risk of preterm birth, according to the results of a systematic review. This finding runs counter to the conclusions reached by three previous reviews. "Because our review is more current and we were unable to demonstrate any benefit to antibiotic treatment, even among various subgroups of women, we believe there is inadequate evidence to justify a policy of screening and antibiotic treatment of high-risk women with bacterial vaginosis to reduce the risk of preterm birth," Dr. Nan Okun, from Mount Sinai Hospital in Toronto, and colleagues note. The findings, which appear in the April issue of Obstetrics and Gynecology, are based on analysis of data from studies identified in a search of Pre-MEDLINE, MEDLINE, EMBASE, and the Cochrane Library. A total of 39 papers were reviewed in detail, including 14 that were used in a meta-analysis. Although antibiotics cut the risk of persistent infection in women with bacterial vaginosis, they had no effect on the risk of preterm birth or its associated morbidities. This lack of effect was observed in both high- and low-risk women. Among women with Trichomonas vaginalis, metronidazole therapy reduced the risk of persistent infection, but did not prevent preterm birth, the investigators found. While this review suggests antibiotic treatment is not useful for preventing preterm births in women with bacterial vaginosis or Trichomonas vaginalis, the authors note that further randomized controlled trials, adequately powered to assess relevant clinical outcomes, are justified. Obstet Gynecol 2005;105:857-868.
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