Antibiotics for UTIs and STDs

SourceLocation and Type of TrialInterventionMaternal OutcomePerinatal/Neonatal Outcome
Wawer et al345Uganda; rural setting; RCTIntervention clusters(n = 12 733, of whom 6609 were HIV-negative) were given broad-spectrum treatment for STDs that consisted of azithromycin (1000 mg single dose), cefixime (400 mg single dose) and metronidazole (2 g single dose). The control group (n = 6124) was untreated.Prevalence rates of STDs other than bacterial vaginosis at the postnatal visit were significantly lower in the intervention group than the control group.There was a 17% reduction in early neonatal death and a 23% reduction in the risk of preterm delivery in the intervention group.
Gichangi et al357Kenya; urban hospital setting; DBRCTPregnant women (n = 320) were randomized into an intervention group (n = 160) and placebo (n = 160). The intervention group received a single oral dose of 2 g cefetamet-pivoxil; the control group received placebo.In the intervention group there were 65% fewer Neisseria gonorrheae cervical infections (P = .04).The intervention had no effect on the rate of stillbirth. However, infants born to mothers in the intervention group were heavier (mean difference 155 g) than those in the placebo group (P = .04). The intervention reduced LBW by 44% (18.7% vs 32.8%) but had no effect on gestational age (P = .01).
Joesoef et al344Indonesia; multicenter trial, urban hospital setting; RCTWomen seeking prenatal care at 14–26 wk of gestational age and who had bacterial vaginosis (n = 681) were given either 2% clindamycin vaginal cream (n = 340) or a placebo cream (n = 341).2 weeks after the completion of the treatment, 88.5% of the women were cured.The rate of preterm delivery (<37 wk) was 15% for clindamycin patients and 13.5% for placebo patients (OR: 1.1; CI: 0.7–1.7). The rate of LBW was 9% for clindamycin patients and 6.8% for placebo patients (OR: 1.3; CI: 0.8–2.4).