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  • Title: Prophylactic antibiotics for suction curettage abortion: results of a clinical controlled trial.
    Author: Levallois P, Rioux JE.
    Journal: Am J Obstet Gynecol; 1988 Jan; 158(1):100-5. PubMed ID: 3276193.
    Abstract:
    The prophylactic use of 300 mg doxycycline at the time of an abortion was evaluated in a randomized controlled trial. In the group with negative chlamydia screening results, only two (0.4%) of 502 patients who received prophylactic treatment developed pelvic infection, compared with 15 (3.0%) of 497 patients who received placebos (p = 0.001). The same effectiveness was found in women with positive chlamydia screening results. Vomiting was the major side effect of the medication and could limit its use. A simulation of selective prophylaxis in women with negative chlamydia screening results showed that its selective use in patients with a history of gonorrhea or in nulliparous women with multiple sex partners could be nearly two thirds as effective as general prophylaxis. Prophylactic doxycycline (tetracycline) antibiotic was tested in a randomized, double-blind, placebo-controlled trial of 1077 women having suction curettage abortion. All women attending Laval University Hospital family planning clinic for 1st trimester abortion from November 1985 to June 1986 participated in the trial, except those eliminated because of antibiotic allergy or treatment, gonorrhea, or cardiac disease. Doxycycline was given in 100 mg capsules, 1 hour before abortion, and 2 capsules 30 minutes afterward. 2 (0.4%) women without chlamydia who received antibiotic developed pelvic infection, compared to 15 (3.0%) who received placebos (p0.001). In the group with chlamydia, 1 (3.0%) given antibiotic developed pelvic infection, compared to 11 (26.2%) given placebo (p0.009). The only side effect of the medication was vomiting in 18%. All pelvic infections were cured within 2 weeks and no antibiotic resistance was apparent. A simulation of risk factors showed that nulliparity and multiple sex partners were associated with the greatest risk of pelvic infection. Use of doxycycline in these women would be 66% as effective and twice as efficient as general prophylaxis, but prophylactic antibiotics cannot be used without follow-up and observance of specific guidelines.
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