Antibiotics not necessary beyond 48 hours for treatment of septic abortion

January 01, 0001

Antibiotics not necessary beyond 48 hours for treatment of septic abortion

These Brazilian and US authors sought to investigate whether oral antibiotics are necessary, after 48 hours of clinical improvement, in uncomplicated septic abortion. They conducted a randomized double-blind clinical trial including 56 women with uncomplicated septic abortion who were treated with intravenous antibiotics, followed by uterine evacuation. On hospital discharge (day 1), patients were randomized to receive either oral doxycycline plus metronidazole or placebo, until completing 10 days of treatment. Clinical cure was defined by the absence of fever (less than 37.7°C), reduced vaginal bleeding, and minimal or no pelvic pain.

They found: "Cure was observed in all 56 patients. The institutional review board stopped the treatment arm as it was adding risk with no further benefit to the patients. An observational cohort with additional 75 cases was followed up in the no treatment arm and no failure was identified (probability of an adverse event, 0%)."

The authors concluded: "After 48 hours of clinical improvement, antibiotics may not be necessary."

Evacuation of the infected products of conception is the key.

For the full abstract, click here.

Am J Obstet Gynecol 204(4):301.e1-301.e5, April 2011 © 2011 to Mosby, Inc.
Are antibiotics necessary after 48 hours of improvement in infected/septic abortions? A randomized controlled trial followed by a cohort study. Ricardo F. Savaris, Gisele S. de Moraes, Rafael A. Cristovam, R. Daniel Braun. Correspondence to Dr. Savaris: [email protected]

Category: W. Pregnancy, Family Planning. Keywords: antibiotics, doxycycline, metronidazole, septic abortion, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 29 April 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.