Treatment recommendations for bacterial vaginosis in pregnant women.
Treatment recommendations for bacterial vaginosis in pregnant women.
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孕妇细菌性阴道病的治疗建议。
DOI：
10.1086/375271
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发表时间：
2003
期刊：
影响因子：
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通讯作者：
Carey,JChristopher
中科院分区：
文献类型：
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作者：
Klebanoff,MarkA;Guise,Jeanne-Marie;Carey,JChristopher
先生-我们认为，Koumann等人[1]在他们最近对孕妇细菌性阴道病(BV)治疗适应症的审查中提出的数据值得提出更保守的建议。他们指出，几项治疗BV的研究表明，在以前有过早产经历的高危女性中，BV的治疗对减少早产有好处。我们同意一部分有早产风险的BV妇女可以从BV治疗中受益；然而，我们更担心的是，用于治疗BV的抗生素似乎会增加其他妇女的早产率。库曼斯和他的同事[1]实际上忽视了这些潜在的危害。对高危女性进行BV筛查和治疗的热情是基于3项小规模研究[2-4]。在提出国家卫生政策建议时，重要的是要考虑到在推广治疗时是否有可能取得令人满意的结果。在全美多个学术医疗中心进行的更大规模的国家儿童健康与人类发展研究所(NICHD)研究[5]的结果表明，当推广时，这种益处可能并不成立。在这项研究中，接受过甲硝唑治疗的有早产史的妇女有
Sir—We believe that the data presented by Koumans et al.[1] in their recent review of the indications for treatment of bacterial vaginosis (BV) in pregnant women warrant more conservative recommendations. They noted that several studies of treatment of BV have shown a benefit in reducing preterm births among high-risk women who have had a previous preterm birth. We agree that a portion of women with BV who are at high risk for preterm birth may benefit from BV treatment; however, we hold greater concern that the antibiotics used to treat BV appear to increase the rate of preterm birth in other women. Koumans and colleagues [1] virtually ignored these potential harms.The enthusiasm for screening for and treating BV in high-risk women is based on 3 small studies [2–4]. When making national health policy recommendations, it is important to consider whether promising results are likely to hold when treatment is generalized. Results from the larger National Institute of Child Health and Human Development (NICHD) study [5], which was conducted at multiple academic medical centers across the United States, suggest that the benefits may not hold when generalized. In this study, women with a prior preterm birth who were treated with metronidazole had