Can antibiotics prevent preterm birth—the pro and con debate

@article{Lamont2005CanAP,
  title={Can antibiotics prevent preterm birth—the pro and con debate},
  author={Ronald F Lamont},
  journal={BJOG: An International Journal of Obstetrics \& Gynaecology},
  year={2005},
  volume={112}
}
  • R. Lamont
  • Published 16 February 2005
  • Medicine
  • BJOG: An International Journal of Obstetrics & Gynaecology
Studies using different diagnostic methods and outcome parameters have used different antibiotics and dose/administration regimes to women of differing risk of preterm birth with, not surprisingly, different results. Studies which have shown benefit have been criticised for having either poor methodology, low sample size or having only showed benefit after a non‐prespecified subgroup analysis. Studies which have failed to show any benefit have been criticised for unacceptable methods of… 
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References

SHOWING 1-10 OF 31 REFERENCES
Antibiotic treatment of preterm labor with intact membranes: a multicenter, randomized, double-blinded, placebo-controlled trial.
TLDR
The results of this study do not support the routine use of antibiotic administration to women in preterm labor with intact membranes.
Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial
TLDR
Evidence is provided that antibiotics should not be routinely prescribed for women in spontaneous preterm labour without evidence of clinical infection, and antibiotic prescription was associated with a lower occurrence of maternal infection.
Interventions for treating bacterial vaginosis in pregnancy.
TLDR
The current evidence does not support screening and treating all pregnant women for bacterial vaginosis to prevent preterm birth and its consequences, and there is some suggestion that detection and treatment of bacterialvaginosis early in pregnancy may prevent a proportion of these women having a further pre term birth.
Antibiotics for treating bacterial vaginosis in pregnancy.
TLDR
Little evidence is provided that screening and treating all pregnant women with asymptomatic bacterial vaginosis will prevent preterm birth and its consequences, and there is some suggestion that treatment of bacterialvaginosis may reduce the risk of preterm prelabour rupture of membranes and low birthweight.
Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study.
TLDR
Treatment of bacterial vaginosis with metronidazole was effective in reducing preterm births in patients with a history of prematurity in the preceding pregnancy.
Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial
TLDR
Treatment of asymptomatic abnormal vaginal flora and bacterial vaginosis with oral clindamycin early in the second trimester significantly reduces the rate of late miscarriage and spontaneous preterm birth in a general obstetric population.
Prospective randomised controlled trial of an infection screening programme to reduce the rate of preterm delivery
Abstract Objective To evaluate whether a screening strategy in pregnancy lowers the rate of preterm delivery in a general population of pregnant women. Design Multicentre, prospective, randomised
Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis.
TLDR
Treatment with metronidazole and erythromycin during the second trimester reduced rates of premature delivery in women with bacterial vaginosis and an increased risk for preterm delivery.
Use of microbial cultures and antibiotics in the prevention of infection-associated preterm birth.
TLDR
Antepartum treatment of lower genital tract infection or bacterial colonization has been found to reduce the incidence of preterm birth in the case of asymptomatic bacteriuria and bacterial vaginosis in selected patients but has been proved to be ineffective for vaginal colonization with organisms such as Ureaplasma urealyticum and group B streptococcus.
Intravaginal Clindamycin to Reduce Preterm Birth in Women With Abnormal Genital Tract Flora
TLDR
A 2% clindamycin vaginal cream, when compared with placebo administered to women with abnormal genital tract flora before 20 weeks' gestation, can reduce the incidence of preterm birth by 60% and hence the need for neonatal intensive care.
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