| Clinical and cervical cytokine response to treatment with oral or vaginal metronidazole for bacterial vaginosis during pregnancy: a randomized trial. | |
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MedLine Citation:
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PMID: 12962937 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Mark H Yudin; Daniel V Landers; Leslie Meyn; Sharon L Hillier |
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Publication Detail:
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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:
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Title: Obstetrics and gynecology Volume: 102 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2003 Sep |
Date Detail:
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Created Date: 2003-09-09 Completed Date: 2003-10-15 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 527-34 Citation Subset: AIM; IM |
Affiliation:
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St. Michael's Hospital, Toronto, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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U01 AI 47785/AI/NIAID NIH HHS |
| Chemical | |
Reg. No./Substance:
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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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