Document Detail


Clinical and cervical cytokine response to treatment with oral or vaginal metronidazole for bacterial vaginosis during pregnancy: a randomized trial.
MedLine Citation:
PMID:  12962937     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the efficacy of oral versus vaginal metronidazole treatment in pregnant women with bacterial vaginosis, and to compare cytokine profiles (interleukin-1beta, -6, and -8) in the cervical secretions of these women before and after treatment. METHODS: Pregnant women with bacterial vaginosis diagnosed both by Gram stain and clinical criteria were randomized to receive oral (n=52) or vaginal (n=50) metronidazole therapy. Cervical specimens for cytokine analysis and vaginal fluid for evaluation of bacterial vaginosis were obtained at baseline and 4 weeks after treatment. RESULTS: There was no significant difference in therapeutic cure rates (defined as a Gram stain score of 0-3 and the absence of all four clinical signs of bacterial vaginosis) between the two groups (71% and 70% for the oral and vaginal groups, respectively, P=1.0). Cervical levels of interleukin-1beta, -6, and -8 were significantly lower after treatment among the 72 women cured of bacterial vaginosis (P<.001, P=.001, and P=.02, respectively) but not among women who failed to respond to therapy. For interleukin-1beta and -6, a significant decrease in cytokine level was observed in both the oral and vaginal treatment groups. CONCLUSION: One week of oral metronidazole and 5 days of intravaginal metronidazole are equally efficacious for treatment of bacterial vaginosis during pregnancy. The decrease in cervical interleukin-1beta, -6, and -8 levels among women who established a normal flora after treatment but not among those with persistent bacterial vaginosis suggests a direct linkage between vaginal flora abnormalities and elevated cervical levels of interleukin-1beta, -6, and -8.
Authors:
Mark H Yudin; Daniel V Landers; Leslie Meyn; Sharon L Hillier
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  102     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-09     Completed Date:  2003-10-15     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  527-34     Citation Subset:  AIM; IM    
Affiliation:
St. Michael's Hospital, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Administration, Intravaginal
Administration, Oral
Adolescent
Adult
Cytokines / drug effects*,  metabolism
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Gestational Age
Humans
Interleukin-1 / metabolism
Interleukin-6 / metabolism
Interleukin-8 / metabolism
Metronidazole / administration & dosage*
Pregnancy
Pregnancy Complications, Infectious / diagnosis,  drug therapy*
Pregnancy Outcome*
Probability
Reference Values
Severity of Illness Index
Treatment Outcome
Vaginosis, Bacterial / drug therapy*,  microbiology
Grant Support
ID/Acronym/Agency:
U01 AI 47785/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Cytokines; 0/Interleukin-1; 0/Interleukin-6; 0/Interleukin-8; 443-48-1/Metronidazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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