Prophylactic Antibiotics in Women with a History of Pelvic Inflammatory Disease Undergoing First‐Trimester Abortion

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Abstract
In a double-blind controlled trial the effect of prophylactic metronidazole on postabortal infection in women with a history of pelvic inflammatory disease (PID) was assessed. One hundred and thirty-five women were eligible for randomization, of whom 17 were excluded. The regimen consisted of oral metronidazole 400 mg 1 h before the abortion and again 4 and 8 h after, or else placebo. In the placebo group the rate of postabortal PID was 13.0% (7/54) and in the metronidazole group 10.9% (7/64), a non-significant difference (p > 0.7). Women in gestational weeks 11-12 had a significantly increased rate of postabortal PID compared with women in weeks 6-10 (p < 0.005), but this rate was not influenced by the treatment (p > 0.2). Women with parity 1 had a significantly increased rate of postabortal PID compared with women with parity 0 (p < 0.05), but again the treatment did not influence this rate significantly (p > 0.2). The number of hospital days for women in the metronidazole group did not differ significantly from that in the placebo group (p < 0.1). The amount of metronidazole administered for prophylactic and postabortal treatment was significantly greater in the metronidazole group (p < 0.001). The amounts of other antibiotics prescribed showed non-significant differences between the two groups (all p-values > 0.3).