Changes in the vaginal flora after two percent clindamycin vaginal cream in women at high risk of spontaneous preterm birth.
OBJECTIVE
To analyse alterationS in the vaginal flora after 2% clindamycin vaginal cream or placebo administered for the prevention of preterm delivery in high risk women.


METHODS
Observational study during a randomised multicentre double-blind placebo controlled trial.


METHODS
Twelve city hospitals in The Netherlands.


METHODS
One hundred and sixty-eight women were enrolled. Alterations in the vaginal flora could be analysed in one hundred and twenty-four women by comparing the Nugent score on entry to the trial and at 31 weeks' gestation. The Nugent score was classified into normal, intermediate and bacterial vaginosis.


METHODS
Two percent clindamycin vaginal cream or placebo cream administered daily for seven days at week 26 of pregnancy.


RESULTS
Changes in the vaginal flora at week 31 of pregnancy.


RESULTS
The placebo group consisted of 64 women and the clindamycin group of 60 women. At week 31 the vaginal flora was similar to week 26 with placebo cream but changed from normal vaginal flora to intermediate or bacterial vaginosis with 2% clindamycin vaginal cream.


CONCLUSIONS
Obstetricians should not prescribe 2% clindamycin vaginal cream to pregnant women with normal vaginal flora in order to reduce the incidence of preterm birth. because it has no beneficial effects and is actually harmful. 2% Clindamycin vaginal cream encourages the presence of bacterial vaginosis which is epidemiologically associated with preterm birth.
Vermeulen
G M
GM
Department of Obstetrics and Gynaecology, Diaconessenhuis Meppel, The Netherlands.
van Zwet
A A
AA
Bruinse
H W
HW
D000282:Administration, Intravaginal; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002981:Clindamycin / Q000008:administration & dosage; D000075202:Contraindications; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011247:Pregnancy; D016896:Treatment Outcome; D014621:Vagina / Q000382:microbiology*; D014622:Vaginal Creams, Foams, and Jellies; D016585:Vaginosis, Bacterial / Q000139:chemically induced*
D000900:Anti-Bacterial Agents; D014622:Vaginal Creams, Foams, and Jellies; D002981:Clindamycin