zithromax and Salpingitis

The value of antibiotic prophylaxis before insertion of an intrauterine device (IUD) remains uncertain. We undertook a triple-masked, randomised, placebo-controlled trial to find out whether such prophylaxis reduces the rate of IUD removal within 90 days.. 11 clinic sites in southern California enrolled women who requested IUD insertion and were at low risk of sexually transmitted infection according to self-reported medical history. We randomly assigned 1985 participants either 500 mg azithromycin or placebo capsules of identical appearance taken about 1 h before insertion of a Copper T 380A IUD. 118 women did not have an IUD inserted. We followed up 1833 of the remaining 1867 (98%) participants for at least 90 days after insertion.. The rate of IUD removal for any reason other than partial expulsion was 3.8% (35/918) in the antibiotic group and 3.4% (31/915) in the placebo group (relative risk 1.1 [95% CI 0.7-1.8]). The two treatment groups sought medical attention with equal frequency (mean 38 visits per 100 women). During the 90 days after IUD insertion, only one woman from each assignment group had salpingitis, as defined by established criteria.. Prophylaxis with azithromycin did not affect the likelihood that a woman would retain her IUD at 90 days or the frequency of postinsertion medical attention. In appropriately screened women, the risk of upper-genital-tract infection is negligible after IUD insertion, with or without the administration of prophylactic antibiotics.

Topics: Adult; Anti-Bacterial Agents; Antibiotic Prophylaxis; Azithromycin; Doxycycline; Female; Follow-Up Studies; Humans; Intrauterine Device Expulsion; Intrauterine Devices, Copper; Pilot Projects; Risk Factors; Salpingitis; Time Factors

Topics: Anti-Bacterial Agents; Azithromycin; Endometritis; Female; Fluoroquinolones; Humans; Male; Moxifloxacin; Mycoplasma genitalium; Mycoplasma Infections; Salpingitis; Urethritis; Uterine Cervicitis; Vaginosis, Bacterial

Progesterone-treated C3H mice were inoculated under the ovarian bursa with a human Chlamydia trachomatis strain, serovar E, and treated variously from one week before inoculation to two weeks afterwards with a single oral dose of azithromycin. At autopsy, all 27 control mice, not given azithromycin, had histological evidence of salpingitis. Any tubal inflammation in the 139 mice which had received greater than or equal to 60 mg azithromycin/kg was always less severe than that in control mice killed on the same day. This was true also for three of the six mice given azithromycin 25 mg/kg. Salpingitis was prevented in all 38 mice given greater than or equal to 60 mg of azithromycin on the day chlamydiae were inoculated. Inflammation was found in only 35% of mice given 60-80 mg/kg of drug from two to ten days after inoculation and was less severe than in untreated control mice. This dose given later was not as effective in preventing disease. Doses of 200-240 and 100-180 mg/kg given up to a week before inoculation reduced the proportion of mice with salpingitis to 33% and 77%, respectively, while no reduction occurred with 60-80 mg/kg, although lesions were less severe than in control mice. Chlamydiae were not detected in any part of the genital tract when greater than or equal to 60 mg/kg of azithromycin were given on the day of inoculation and were rarely detected when the drug was given a week before or up to 12 days after inoculation. Re-isolation of organisms was not always associated with histological evidence of disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Erythromycin; Female; Mice; Mice, Inbred C3H; Salpingitis