[Ketoconazole and clindamycin efficacy vs oral clindamycin in premature membranes rupture prevention].
BACKGROUND
Vulvovaginitis is one of the main causes of premature membrane rupture.


OBJECTIVE
To evaluate effectiveness of a combination of ketoconazole (400 mg) and clindamycin (100 mg) in vaginal tablets, compared with clindamicyn alone (600 mg/daily) orally, for six days, to prevent premature membrane rupture in patients with vulvovaginitis.


METHODS
Longitudinal, prospective, comparative, randomized, double-blind, double-dummy study in patients older than 18 years, during them third trimester of normoevolutive pregnancy with symptomatic vulvovaginitis. Patients were monitored as out patient. Genital secretion culture and fresh studies were made. Signs and symptoms were evaluated in regular intervals: 4, 7 and 11 days. Pregnancy control was performed every three weeks, until childbirth or premature membrane rupture.


RESULTS
105 patients were included: 53 in the group of ketoconazole and clindamicyn (1), and 52 in the group of clindamycin alone (2). Symptoms were similar in both groups of treatment, without statistically significant differences. A case of group 2 has premature membrane rupture (p = 0.495). C. albicans was cultured in 35% of group 2 and in 11% of group 2. No adverse events with treatments were reported.


CONCLUSIONS
The combination of ketoconazole and cindamycin was effective to prevent premature membrane rupture in patients with vulvovaginitis.
Castillo Huerta
Eugenio
E
Servicio de Ginecología y Obstetricia, Ginecoobstetra certificado por el Consejo Mexicano de Ginecología y Obstetricia, Hospital Civil Dr. Miguel Silva (SSA) de Morelia, Michoacán, México.
Garibay Valencia
Miguel
M
Mirabent-González
Felio
F
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use*; D008137:Longitudinal Studies; D011247:Pregnancy; D011446:Prospective Studies; D014848:Vulvovaginitis / Q000150:complications / Q000517:prevention & control*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D007654:Ketoconazole