Clindamycin to treat abnormal vaginal flora in early pregnancy to prevent PTB

January 01, 0001

Clindamycin to treat abnormal vaginal flora in early pregnancy to prevent PTB

The purpose of this systematic review and meta-analysis of randomized controlled trials by US authors was to determine whether the administration of clindamycin to women with abnormal vaginal flora at less than 22 weeks of gestation reduces the risk of preterm birth and late miscarriage.

They found: "Five trials that comprised 2346 women were included. Clindamycin that was administered at less than 22 weeks of gestation was associated with a significantly reduced risk of preterm birth at less than 37 weeks of gestation and late miscarriage. There were no overall differences in the risk of preterm birth at less than 33 weeks of gestation, low birthweight, very low birthweight, admission to neonatal intensive care unit, stillbirth, peripartum infection, and adverse effects."

The authors concluded: "Clindamycin in early pregnancy in women with abnormal vaginal flora reduces the risk of spontaneous preterm birth at less than 37 weeks of gestation and late miscarriage. There is evidence to justify further randomized controlled trials of clindamycin for the prevention of preterm birth. However, a deeper understanding of the vaginal microbiome, mucosal immunity, and the biology of BV will be needed to inform the design of such trials."

The clinical benefit appears to be marginal based on this relatively small body of evidence.


For the full abstract, click here.

Am J Obstet Gynecol 205:262.e1-262.e8, September 2011 © 2011 to Mosby, Inc.
Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis. Ronald F. Lamont, Chia-Ling Nhan-Chang, Jack D. Sobel, Kimberly Workowski, Agustin Conde-Agudelo, Roberto Romero. Correspondence to: [email protected]

Category: W. Pregnancy, Family Planning. Keywords: antibiotic, bacterial vaginosis, clindamycin, late miscarriage, preterm birth, meta-analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 4 October 2011

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

COVID-19 Resources

WONCA webinars, journal links and more

WONCA position statements

WONCA statements on a variety of issues

PEARLS

577 Individual behavioural counselling helps people to quit smoking 575 Antioxidant vitamin and mineral supplements may be beneficial in age-related macular degeneration 574 Oral antifungals effective for toenail onychomycosis 570 Decision aids beneficial for people facing health treatment or screening decisions 569 Computer-generated reminders on paper benefit quality of care