tetracycline and Abortion--Septic

A septic abortion refers to any abortion (spontaneous or induced) complicated by upper genital tract infection including endometritis or parametritis. The mainstay of treatment of septic abortion is antibiotic therapy alone or in combination with evacuation of retained products of conception. Regimens including broad-spectrum antibiotics are routinely recommended for treatment. However, there is no consensus on the most effective antibiotics alone or in combination to treat septic abortion. This review aimed to bridge this gap in knowledge to inform policy and practice.. To review the effectiveness of various individual antibiotics or antibiotic regimens in the treatment of septic abortion.. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, and POPLINE using the following keywords: 'Abortion', 'septic abortion', 'Antibiotics', 'Infected abortion', 'postabortion infection'. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov for ongoing trials on 19 April, 2016.. We considered for inclusion randomised controlled trials (RCTs) and non-RCTs that compared antibiotic(s) to another antibiotic(s), irrespective of route of administration, dosage, and duration as well as studies comparing antibiotics alone with antibiotics in combination with other interventions such as dilation and curettage (D&C).. Two review authors independently extracted data from included trials. We resolved disagreements through consultation with a third author. One review author entered extracted data into Review Manager 5.3, and a second review author cross-checked the entry for accuracy.. We included 3 small RCTs involving 233 women that were conducted over 3 decades ago.Clindamycin did not differ significantly from penicillin plus chloramphenicol in reducing fever in all women (mean difference (MD) -12.30, 95% confidence interval (CI) -25.12 to 0.52; women = 77; studies = 1). The evidence for this was of moderate quality. "Response to treatment was evaluated by the patient's 'fever index' expressed in degree-hour and defined as the total quantity of fever under the daily temperature curve with 99°F (37.2°C) as the baseline".There was no difference in duration of hospitalisation between clindamycin and penicillin plus chloramphenicol. The mean duration of hospital stay for women in each group was 5 days (MD 0.00, 95% CI -0.54 to 0.54; women = 77; studies = 1).One study evaluated the effect of penicillin plus chloramphenicol versus cephalothin plus kanamycin before and after D&C. Response to therapy was evaluated by "the time from start of antibiotics until fever lysis and time from D&C until patients become afebrile". Low-quality evidence suggested that the effect of penicillin plus chloramphenicol on fever did not differ from that of cephalothin plus kanamycin (MD -2.30, 95% CI -17.31 to 12.71; women = 56; studies = 1). There was no significant difference between penicillin plus chloramphenicol versus cephalothin plus kanamycin when D&C was performed during antibiotic therapy (MD -1.00, 95% CI -13.84 to 11.84; women = 56; studies = 1). The quality of evidence was low.A study with unclear risk of bias showed that the time for fever resolution (MD -5.03, 95% CI -5.77 to -4.29; women = 100; studies = 1) as well as time for resolution of leukocytosis (MD -4.88, 95% CI -5.98 to -3.78; women = 100; studies = 1) was significantly lower with tetracycline plus enzymes compared with intravenous penicillin G.Treatment failure and adverse events occurred infrequently, and the difference between groups was not statistically significant.. We found no strong evidence that intravenous clindamycin alone was better than penicillin plus chloramphenicol for treating women with septic abortion. Similarly, available evidence did not suggest that penicillin plus chloramphenicol was better than cephalothin plus kanamycin for the treatment of women with septic abortion. Tetracyline enzyme antibiotic appeared to be more effective than intravenous penicillin G in reducing the time to fever defervescence, but this evidence was provided by only one study at low risk of bias.There is a need for high-quality RCTs providing reliable evidence for treatments of septic abortion with antibiotics that are currently in use. The three included studies were carried out over 30 years ago. There is also a need to include institutions in low-resource settings, such as sub-Saharan Africa, Latin America and the Caribbean, and South Asia, with a high burden of abortion and health systems challenges.

Topics: Abortion, Septic; Adult; Anti-Bacterial Agents; Cephalothin; Chloramphenicol; Clindamycin; Drug Therapy, Combination; Female; Humans; Kanamycin; Length of Stay; Penicillins; Pregnancy; Randomized Controlled Trials as Topic; Tetracycline

Topics: Abortion, Septic; Anticoagulants; Bacterial Infections; Bacteroides Infections; Chloramphenicol; Clindamycin; Clostridium Infections; Cross Infection; Drug Resistance, Microbial; Female; Genital Diseases, Female; Humans; Lincomycin; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Complications, Infectious; Tetracycline; Thrombophlebitis

Topics: Abortion, Septic; Abscess; Aminoglycosides; Anaerobiosis; Anti-Bacterial Agents; Bacterial Infections; Brain Abscess; Cephalosporins; Chloramphenicol; Clindamycin; Endocarditis, Bacterial; Erythromycin; Female; Humans; Lincomycin; Lung Abscess; Penicillins; Pregnancy; Sepsis; Tetracycline

Puerperal sepsis is any bacterial infection of the genital tract that occurs after childbirth. It is among the leading causes of maternal morbidity and mortality especially in low-income countries including Ethiopia. The aim of this study was to determine the proportion of bacterial isolates, their antimicrobial susceptibility profile and factors associated with puerperal sepsis among post-partum/aborted women at a Referral Hospital in Bahir Dar, Northwest Ethiopia.. A cross sectional study was conducted from January to May 2017 among 166 post-partum/aborted women admitted to Felege Hiwot Referral Hospital for medical services and suspected for puerperal sepsis.. Socio-demographic data and associated factors were collected using structured questionnaire. Bacteria were isolated and identified from blood samples on Trypton soya broth, blood, Chocolate and MacConkey agars following standard bacteriological procedures. The VITEK 2 identification and susceptibility testing system was used to determine the antimicrobial susceptibility profiles of bacterial isolates. Data were entered and analyzed using SPSS version 20. Factors associated with puerperal sepsis were considered statistically significant at. The overall proportion of bacterial isolates among post-partum/aborted women was 33.7% (56/166); of which 55.4% was caused by Gram-negative and 44.6% was by Gram-positive bacteria. The most frequently isolated bacteria were. About one third of post-partum/aborted women suspected for puerperal sepsis were infected with one or more bacterial isolates. Significant proportion of bacterial isolates showed mono and multi-drug resistance for the commonly prescribed antibiotics. Women with multiparous parity were more likely to develop puerperal sepsis than primiparous parity.

Topics: Abortion, Septic; Adult; Ampicillin; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Cefazolin; Cross-Sectional Studies; Drug Resistance, Multiple, Bacterial; Ethiopia; Female; Humans; Microbial Sensitivity Tests; Phylogeny; Pregnancy; Puerperal Infection; Risk Factors; Tetracycline; Young Adult

Bitches with naturally occurring Brucella canis infection were treated with combined antibiotic therapy consisting of tetracycline, dihydrostreptomycin, and trimethoprim-sulfadiazine. After treatment, all but 1 bitch became abacteremic, and serologic titers declined for a variable length of time (3 months to 1 years). Abortion did not occur while these bitches were abacteremic. Although sequential antibiotic therapy for 6 weeks did not eradicate Brucella canis from affected bitches, it did not prevent abortion. The number of live pups whelped and weaned by treated bitches was comparable with that in bitches before they became infected.

Topics: Abortion, Septic; Abortion, Veterinary; Animals; Brucellosis; Dihydrostreptomycin Sulfate; Dog Diseases; Dogs; Drug Combinations; Drug Therapy, Combination; Estrus; Female; Pregnancy; Pregnancy Complications, Infectious; Sepsis; Sulfadiazine; Tetracycline; Trimethoprim

Topics: Abortion, Septic; Adolescent; Adult; Anti-Bacterial Agents; Antitoxins; Carbenicillin; Cephalosporins; Complement System Proteins; Endometritis; Escherichia coli Infections; Female; Humans; Methicillin; Muramidase; Penicillin G; Pregnancy; Staphylococcal Infections; Streptococcal Infections; Tetracycline; Tetracyclines

Topics: Abortion, Septic; Adrenal Cortex Hormones; Bicarbonates; Blood Transfusion; Chloramphenicol; Digoxin; Escherichia coli Infections; Exchange Transfusion, Whole Blood; Female; Gentamicins; Humans; Hysterectomy; Isoproterenol; Kanamycin; Penicillins; Plasma Substitutes; Pregnancy; Puerperal Infection; Sepsis; Shock, Septic; Tetracycline

Topics: Abortion, Septic; Acute Kidney Injury; Chloramphenicol; Female; Humans; India; Parity; Penicillins; Pregnancy; Tetracycline; Time Factors

Topics: Abortion, Septic; Acute Kidney Injury; Antitoxins; Chloramphenicol; Clostridium Infections; Clostridium perfringens; Exchange Transfusion, Whole Blood; Female; Heparin; Humans; Hysterectomy; Mannitol; Metaraminol; Methylprednisolone; Penicillins; Pregnancy; Streptomycin; Tetracycline

Topics: Abortion, Septic; Adult; Anti-Bacterial Agents; Clostridium Infections; Curettage; Drug Synergism; Female; Gas Gangrene; Humans; Kanamycin; Penicillins; Pregnancy; Sepsis; Tetracycline

Topics: Abortion, Septic; Adult; Aged; Anti-Inflammatory Agents; Balsams; Chymotrypsin; Female; Fever; Genital Diseases, Female; Humans; Middle Aged; Pregnancy; Puerperal Infection; Tetracycline; Trypsin

Topics: Abortion, Septic; Adult; Anti-Inflammatory Agents; Female; Genital Diseases, Female; Humans; Middle Aged; Pregnancy; Puerperal Disorders; Tetracycline

Topics: Abortion, Septic; Administration, Oral; Female; Humans; Infant, Newborn; Pregnancy; Streptodornase and Streptokinase; Tetracycline

Topics: Abortion, Septic; Ampicillin; Chloramphenicol; Clostridium; Clostridium Infections; Escherichia coli Infections; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Kanamycin; Klebsiella Infections; Penicillin G; Pregnancy; Streptomycin; Tetracycline

Topics: Abortion, Septic; Adult; Female; Humans; Infections; Pelvis; Penicillins; Pregnancy; Tetracycline

Topics: Abortion, Septic; Adult; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Oleandomycin; Pregnancy; Tetracycline

Topics: Abortion, Septic; Adult; Blood Urea Nitrogen; Bronchopneumonia; Female; Humans; Jaundice; Liver Diseases; Male; Middle Aged; Pregnancy; Pregnancy Complications; Pyelonephritis; Rectovaginal Fistula; Tetracycline; Urea

Topics: Abortion, Induced; Abortion, Septic; Abortion, Spontaneous; Female; Fever; Humans; Pregnancy; Tetracycline

Topics: Abortion, Septic; Anti-Bacterial Agents; Bile Ducts; Chloramphenicol; Emetine; Escherichia coli Infections; Female; Humans; Kanamycin; Neomycin; Oxytetracycline; Paraplegia; Penicillins; Peritonitis; Pregnancy; Pressure Ulcer; Pseudomonas Infections; Pyelonephritis; Pyoderma; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Abortion, Septic; Anti-Bacterial Agents; Female; Gynecology; Humans; Mastitis; Obstetrics; Oleandomycin; Peritonitis; Pleuropneumonia; Pregnancy; Puerperal Infection; Salpingitis; Staphylococcal Infections; Tetracycline

Topics: Abortion, Criminal; Abortion, Septic; Anti-Bacterial Agents; Anuria; Biopsy; Criminals; Curettage; Diuresis; Eclampsia; Female; Fever; Hemoglobinuria; Hemolysis; Humans; Jaundice; Kidney Cortex Necrosis; Kidney Diseases; Nephritis; Nephritis, Interstitial; Penicillins; Pregnancy; Sepsis; Tetracycline

Topics: Abortion, Criminal; Abortion, Septic; Acute Kidney Injury; Adrenal Cortex Hormones; Anti-Bacterial Agents; Bacillus; Chloramphenicol; Clostridium perfringens; Criminals; Female; Gas Gangrene; Hemoglobinuria; Hemolysis; Humans; Kidneys, Artificial; Oleandomycin; Pigmentation Disorders; Pregnancy; Renal Insufficiency; Sepsis; Tetracycline