Evidence that antibiotic administration is effective in treating a subset of patients with intra-amniotic infection/inflammation presenting with cervical insufficiency

Cervical insufficiency is a risk factor for spontaneous mid-trimester abortion or early preterm birth. Intra-amniotic infection has been reported in 8-52% of such patients, and intra-amniotic inflammation in 81%. Therefore, it is possible that antibiotic administration can eradicate intra-amniotic infection/inflammation and improve pregnancy outcome.

PRB researchers reported the outcome of antibiotic treatment in patients with cervical insufficiency and intra-amniotic infection/inflammation. All patients underwent amniocentesis to evaluate the microbiologic and inflammatory status of the amniotic cavity. Three antibiotics (ceftriaxone, clarithromycin, and metronidazole) were administered. Treatment success was defined as the resolution of intra-amniotic infection/inflammation or delivery at or after 34 weeks of gestation. Eradication of intra-amniotic infection/inflammation was achieved in 75% of patients with cervical insufficiency who were treated with antimicrobial agents, and the overall treatment success was 59%. Such observations provide strong evidence that antibiotic administration can be effective in treating intra-amniotic infection/inflammation in patients with cervical insufficiency.

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