Clindamycin benefits pregnant women with BV: early treatment optimal.(Obstetrics)

PLAYA HERRADURA, COSTA RICA --Clindamycin use was associated with a significant reduction in the rates of late miscarriage and preterm birth in women with asymptomatic abnormal vaginal flora or bacterial vaginosis in a randomized, controlled study in a general obstetric population.

Second trimester loss occurred in 0.8% of 241 women with bacterial vaginosis (BV) treated with clindamycin, compared with 4.2% of 238 women given placebo. Other differences in pregnancy outcomes that were statistically significant using a univariate analysis included spontaneous preterm delivery (4.6% vs. 11%) and live term deliveries (91% vs. 83%), Dr. Phillip Hay said at a conference on vaginitis sponsored by Imedex.

Differences in induced preterm delivery (3.3% clindamycin group versus 1.3% placebo group) were not statistically significant. There was one intrauterine death in each group (0.4%). There were no serious adverse events in either group, said Dr. Hay, senior lecturer, department of genitourinary medicine, St. George's Hospital Medical School in London. Some of the results of the study were previously published (Lancet 361[9362]:983-88, 2003).

The greatest apparent benefit of treatment was for women with a Nugent's score of 10, signifying the worst B7 A subanalysis of only those women showed 89% had a live, term delivery versus 61% of women taking a placebo. The difference, however, was not statistically significant because of small numbers. Likewise, there was not enough statistical power in the cohort to show a statistically significant difference by ethnicity.

Previous findings suggest that timing of treatment is important to thwart second trimester loss, which is a more common experience in women with BV than in uninfected women.

"Second trimester miscarriage is more definitively ...