The importance of the removal of the intrauterine device in genital colonization by actinomyces.
OBJECTIVE
To determine whether, in addition to treatment with antibiotics, it is necessary to remove the intrauterine device (IUD) to eliminate genital colonization by Actinomyces.


METHODS
A randomized clinical trial was carried out. Patients were divided into two groups. The intervention group did not have their IUDs removed, while the control group did. Both groups were treated with trimethoprim and sulfamethoxazole. A total of 43 patients were included.


RESULTS
The patients from the intervention group and the control group proved to be comparable. The post-intervention cytology smear tested negative for Actinomyces in 100% of the patients whose IUD had been removed and in 66.7% of those whose IUD had not been removed (p = 0.005). The probability that colonization by Actinomyces will continue if the IUD is not removed is greater the longer the patient has been exposed to the IUD. After 24 months, relative risk (RR) = 2, after 36 months RR = 2.16 and after 48 months RR = 2.66.


CONCLUSIONS
The removal of the IUD has been effective in genital colonization by Actinomyces. The protective effect exerted by the removal of the IUD was found to be greater in proportion to the length of time the patient had used it.
Bonacho
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Centro de Orientación Familiar Municipal-SERGAS, A Coruña, España.
Pita
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Gómez-Besteiro
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MI
D000190:Actinomyces / Q000302:isolation & purification*; D000196:Actinomycosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015169:Colony Count, Microbial; D020878:Device Removal; D005260:Female; D005831:Genital Diseases, Female / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D012306:Risk; D013420:Sulfamethoxazole / Q000627:therapeutic use; D013997:Time Factors; D014295:Trimethoprim / Q000627:therapeutic use; D014626:Vaginal Smears
D000900:Anti-Bacterial Agents; D014295:Trimethoprim; D013420:Sulfamethoxazole