FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1985384690> ?p ?o ?g. }

• W1985384690 endingPage "584" @default.
• W1985384690 startingPage "583" @default.
• W1985384690 abstract "The metaanalysis of Hutzal et al1Hutzal C.E. Boyle E.M. Kenyon S.L. et al.Use of antibiotics for the treatment of preterm parturition and prevention of neonatal morbidity: a metaanalysis.Am J Obstet Gynecol. 2008; 199: 620.e1-620.e8Abstract Full Text Full Text PDF PubMed Scopus (87) Google Scholar is novel in that it measures the effect of antibiotics used prophylactically for preterm prelabor rupture of the membranes (PPROM) and therapeutically for spontaneous preterm labor (SPTL) before 34 weeks' gestation, rather than at later gestations when preterm birth (PTB) is more common but is associated with lower rates of neonatal mortality and morbidity.See related article, page 620 See related article, page 620 The findings confirm that prophylactic antibiotics in PPROM confer benefit with respect to latency and fetomaternal infectious morbidity. The findings do not indicate the best antibiotic regimen. The most appropriate antibiotic combination to prevent PTB should be active against those organisms or conditions known to be associated with late miscarriage and PTB, such as bacterial vaginosis (BV) or BV-related organisms (eg, group B hemolytic streptococcus [GBS]), enteropharyngeal organisms, mycoplasmas, and anaerobes.2Rosenstein I.J. Morgan D.J. Sheehan M. Lamont R.F. Taylor-Robinson D. Bacterial vaginosis in pregnancy—distribution of bacterial species in different gram stain categories of the vaginal flora.J Med Microbiol. 1996; 45: 120-126Crossref PubMed Scopus (98) Google Scholar Erythromycin, coamoxiclav, and metronidazole are active against some but not all of these organisms. Clindamycin, used alone or in combination with erythromycin, would cover the range of organisms likely to be present, but neither regimen has been tested or recommended. In contrast, at the same gestational age (< 34 completed weeks of gestation), antibiotics used prophylactically in women in SPTL with intact membranes conferred no benefit with respect to latency. Length of stay, clinically diagnosed neonatal infection, and histologic chorioamnionitis were less following the use of antibiotics for women in SPTL. Together with the range of antibiotics used, this raises the question of whether these benefits were caused by inadvertent treatment of maternal GBS colonization and prevention of early-onset GBS disease of the newborn. The studies included a span of 17 years of obstetric practice, during which time much has changed, such as use of antepartum glucocorticoids, the diagnosis of SPTL, and the appreciation that abnormal genital tract colonization is rarely caused by a single organism but is usually polymicrobial. The studies in this metaanalysis which screened for abnormal genital tract colonization tended to look for a single organism. This study with 89% weighting for the use of antibiotics therapeutically in SPTL carried out no objective measure of abnormal colonization before administering antibiotics.3Kenyon S.L. Taylor D.J. Tarnow-Mordi W. Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial ORACLE Collaborative Group.Lancet. 2001; 357: 989-994Abstract Full Text Full Text PDF PubMed Scopus (339) Google Scholar This means that up to 60% of women given antibiotics in this study may not have had abnormal genital tract colonization, under which circumstances it is a self-fulfilling prophecy that antibiotics would not have helped. In addition, by being given without objective evidence of abnormal genital tract flora, and in contrast to the putative benefit of treating abnormal flora, antibiotic therapy may have resulted in decimation of normal flora with the potential for an increase in fetomaternal infectious morbidity. SPTL is an inflammatory process mediated through a change in balance between stimulatory and inhibitory factors. Much of the mortality and morbidity associated with PTB is caused by inflammatory lung and brain tissue damage4Yoon B.H. Romero R. Park J.S. et al.Fetal exposure to an intra-amniotic inflammation and the development of cerebral palsy at the age of three years.Am J Obstet Gynecol. 2000; 182: 675-681Abstract Full Text Full Text PDF PubMed Scopus (613) Google Scholar and subsequent cerebral palsy. By the time a woman is admitted in genuine SPTL, particularly when this is caused by infection, there may already be irreversible changes in the myometrium and uterine cervix because of this inflammatory process,5Romero R. Espinoza J. Kusanovic J.P. et al.The preterm parturition syndrome.BJOG. 2006; 113: 17-42Crossref PubMed Scopus (898) Google Scholar which renders interventions such as tocolytics and antibiotics at best unsuccessful, and at worst, more likely to cause fetomaternal infectious morbidity. This being the case, the view that the use of antibiotics is unhelpful for prolongation of gestation in women who are already in SPTL will be supported by the findings of this metaanalysis. Nevertheless, others have demonstrated that, at the limits of viability, where “therapeutic nihilism” must be balanced against “nothing to lose,” good results have been obtained using a combination of tocolytics (sulindac, atosiban, and terbutaline), antepartum glucocorticoids, and antibiotics (cephalexin and metronidazole).6Ingemarsson I. Combination therapy.BJOG. 2005; 112: 89-93Crossref PubMed Scopus (17) Google Scholar The earlier in pregnancy at which a woman delivers, the more likely this is to be caused by infection.7Lamont R.F. Can antibiotics prevent preterm birth—the pro and con debate?.BJOG. 2005; 112: 67-73Crossref PubMed Scopus (45) Google Scholar The earlier in pregnancy at which abnormal colonization is detected, the greater the risk of late miscarriage and PTB.8Lamont R.F. Bacterial vaginosis.in: Critchley H. Bennett P. Thornton S. Preterm birth. RCOG Press, London2004: 163-180Google Scholar Abnormal genital tract colonization detected early in pregnancy, even if this reverts to normal, is associated with an increased risk of late miscarriage and PTB,9Rosenstein I.J. Morgan D.J. Lamont R.F. et al.Effect of intravaginal clindamycin cram on pregnancy outcome and on abnormal vaginal microbial flora of pregnant women.Infect Dis Obstet Gynecol. 2000; 8: 158-165PubMed Google Scholar suggesting that whatever damage is caused by infection and inflammation, this occurs early in pregnancy and persists. It follows that if antibiotics are to be successful in reducing the incidence of SPTL and PTB and the associated fetomaternal infectious mortality and morbidity, these must be used in women at risk of PTB of infectious etiology based on objective evidence (ie, abnormal genital tract flora detected on examination of vaginal secretions). The antibiotics used must be active against the likely organisms responsible but also used early in pregnancy before the damaging and irreversible effects of inflammatory tissue damage has occurred. A number of recent studies that used clindamycin (which is active against those organisms associated with PTB) in women at risk of PTB of infectious etiology (objective evidence of abnormal genital tract colonization) in early pregnancy (before long-term infection and inflammatory tissue damage might have occurred) have shown a significant 40% to 60% reduction in the incidence of PTB.10Lamont R.F. Duncan S. Mandal D. Bassett P. Intravaginal clindamycin to reduce preterm birth in women with abnormal genital tract flora.Obstet Gynecol. 2003; 101: 516-522Crossref PubMed Scopus (141) Google Scholar, 11Ugwumadu A. Manyonda I. Reid F. Hay P. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised clinical trial.Lancet. 2003; 361: 983-988Abstract Full Text Full Text PDF PubMed Scopus (281) Google Scholar, 12Kiss H. Petricevic L. Husslein P. Prospective randomised controlled trial of an infection screening programme to reduce the rate of preterm delivery.BMJ. 2004; 329: 371-375Crossref PubMed Google Scholar, 13Larsson P.-G. Carlsson B. Jakobsson T. Forsum U. Late miscarriage and preterm birth after treatment with clindamycin: a randomised consent design study according to Zelen.BJOG. 2006; 113: 629-637Crossref PubMed Scopus (63) Google Scholar The lack of benefit from the therapeutic use of antibiotics in women already in SPTL demonstrated in this metaanalysis must not be confused with the benefits of the antibiotics used prophylactically in women with PPROM or the appropriate antibiotics used successfully early in the second trimester of pregnancy in women at risk of PTB of infectious etiology for the prevention of late miscarriage and early PTB.10Lamont R.F. Duncan S. Mandal D. Bassett P. Intravaginal clindamycin to reduce preterm birth in women with abnormal genital tract flora.Obstet Gynecol. 2003; 101: 516-522Crossref PubMed Scopus (141) Google Scholar, 11Ugwumadu A. Manyonda I. Reid F. Hay P. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised clinical trial.Lancet. 2003; 361: 983-988Abstract Full Text Full Text PDF PubMed Scopus (281) Google Scholar, 12Kiss H. Petricevic L. Husslein P. Prospective randomised controlled trial of an infection screening programme to reduce the rate of preterm delivery.BMJ. 2004; 329: 371-375Crossref PubMed Google Scholar, 13Larsson P.-G. Carlsson B. Jakobsson T. Forsum U. Late miscarriage and preterm birth after treatment with clindamycin: a randomised consent design study according to Zelen.BJOG. 2006; 113: 629-637Crossref PubMed Scopus (63) Google Scholar Use of antibiotics for the treatment of preterm parturition and prevention of neonatal morbidity: a metaanalysisAmerican Journal of Obstetrics & GynecologyVol. 199Issue 6PreviewWe conducted a metaanalysis to determine whether antibiotics prolong pregnancy and reduce neonatal morbidity in preterm premature rupture of membranes (PPROM) and preterm labor (PTL) at 34 weeks or less. Full-Text PDF" @default.
• W1985384690 created "2016-06-24" @default.
• W1985384690 creator A5022874050 @default.
• W1985384690 date "2008-12-01" @default.
• W1985384690 modified "2023-09-23" @default.
• W1985384690 title "Antibiotics used in women at risk of preterm birth" @default.
• W1985384690 cites W13504714 @default.
• W1985384690 cites W1521618898 @default.
• W1985384690 cites W1998861228 @default.
• W1985384690 cites W1998952411 @default.
• W1985384690 cites W2051868855 @default.
• W1985384690 cites W2078797436 @default.
• W1985384690 cites W2122198409 @default.
• W1985384690 cites W2140678893 @default.
• W1985384690 cites W2142079607 @default.
• W1985384690 cites W2158766906 @default.
• W1985384690 cites W4246536314 @default.
• W1985384690 doi "https://doi.org/10.1016/j.ajog.2008.07.007" @default.
• W1985384690 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/19084094" @default.
• W1985384690 hasPublicationYear "2008" @default.
• W1985384690 type Work @default.
• W1985384690 sameAs 1985384690 @default.
• W1985384690 citedByCount "14" @default.
• W1985384690 countsByYear W19853846902012 @default.
• W1985384690 countsByYear W19853846902014 @default.
• W1985384690 countsByYear W19853846902015 @default.
• W1985384690 countsByYear W19853846902016 @default.
• W1985384690 countsByYear W19853846902023 @default.
• W1985384690 crossrefType "journal-article" @default.
• W1985384690 hasAuthorship W1985384690A5022874050 @default.
• W1985384690 hasBestOaLocation W19853846901 @default.
• W1985384690 hasConcept C131872663 @default.
• W1985384690 hasConcept C177713679 @default.
• W1985384690 hasConcept C501593827 @default.
• W1985384690 hasConcept C71924100 @default.
• W1985384690 hasConcept C86803240 @default.
• W1985384690 hasConcept C89423630 @default.
• W1985384690 hasConceptScore W1985384690C131872663 @default.
• W1985384690 hasConceptScore W1985384690C177713679 @default.
• W1985384690 hasConceptScore W1985384690C501593827 @default.
• W1985384690 hasConceptScore W1985384690C71924100 @default.
• W1985384690 hasConceptScore W1985384690C86803240 @default.
• W1985384690 hasConceptScore W1985384690C89423630 @default.
• W1985384690 hasIssue "6" @default.
• W1985384690 hasLocation W19853846901 @default.
• W1985384690 hasLocation W19853846902 @default.
• W1985384690 hasOpenAccess W1985384690 @default.
• W1985384690 hasPrimaryLocation W19853846901 @default.
• W1985384690 hasRelatedWork W11937737 @default.
• W1985384690 hasRelatedWork W2037947393 @default.
• W1985384690 hasRelatedWork W2046872660 @default.
• W1985384690 hasRelatedWork W2391778245 @default.
• W1985384690 hasRelatedWork W2783428915 @default.
• W1985384690 hasRelatedWork W4200145193 @default.
• W1985384690 hasRelatedWork W4250651714 @default.
• W1985384690 hasRelatedWork W4252371801 @default.
• W1985384690 hasRelatedWork W4292236266 @default.
• W1985384690 hasRelatedWork W4300011530 @default.
• W1985384690 hasVolume "199" @default.
• W1985384690 isParatext "false" @default.
• W1985384690 isRetracted "false" @default.
• W1985384690 magId "1985384690" @default.
• W1985384690 workType "article" @default.