Are Antibiotics after a Septic Abortion Necessary?
This study by Savaris et al. (AJOG, 2011) aimed to determine if oral antibiotics are necessary, after 48 hours of clinical improvement, following an uncomplicated septic abortion.
Blinded Randomized Controlled Trial (RCT)
56 women with uncomplicated septic abortions were given intravenous antibiotics, followed by uterine evacuation. The two arms of the study were (1) at discharge, patients were given oral doxycycline plus metronidazole or (2) a placebo for ten days. If a woman had no fever, reduced vaginal bleeding, and little or no pelvic pain, she was considered clinically “cured.” All 56 patients were cured, and the treatment arm was stopped early due to determination of lack of benefit with potential risk. The authors then pursued a follow up study where they monitored 75 women who received no antibiotic treatment at discharge and cure was obtained in all cases. The authors suggest that if patients have shown 48 hours of clinical improvement, oral antibiotics may not be necessary.
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