Abstract
Objectives
Routine provision of antibiotics following medical abortion is common yet practitioners
and professional societies differ on its utility. Our study compares the side effects
experienced by women who were prescribed doxycycline following medical abortion to
those who were not and assesses the adherence to one prescribed regimen.
Study design
This was a prospective, observational, open-label study from a convenience sample.
Women seeking medical abortion were enrolled in nine study sites, including four clinics
that routinely prescribe a seven-day course of doxycycline (Doxycycline arm) and five
clinics that do not routinely prescribe any antibiotics (No Doxycycline arm). Seven
to fourteen days following the administration of mifepristone, women were asked to
self-administer a computer-based survey. The survey asked about side effects experienced
(both arms) and adherence to the regimen (Doxycycline arm only).
Results
Five hundred eighty-one women were enrolled (278 in the Doxycycline arm and 303 in
the No Doxycycline arm). There was a trend toward increased nausea in the Doxycycline
arm (47.8% vs. 40.9%; p=.056) and a statistically significant difference in vomiting
(25.2% vs. 18.5%; p=.032). Almost all women in the Doxycycline arm reported taking
at least one pill, however only 28.3% reported “perfect adherence.” The most common
reasons reported for taking fewer pills than instructed were that participants were
still taking them (beyond 7 days) or that they forgot to take them.
Conclusion
Women who were prescribed doxycycline following medical abortion reported moderate
adherence and experienced significantly more vomiting than their counterparts.
Implications
In the absence of robust evidence that prescribing 7 days of doxycycline following
medical abortion is effective at reducing serious infections, these data can assist
the public health community with deciding whether routine provision is the most appropriate
strategy.
Keywords
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Article info
Publication history
Published online: September 09, 2014
Accepted:
September 2,
2014
Received in revised form:
September 2,
2014
Received:
July 1,
2014
Footnotes
☆The authors declare no conflicts of interest.
☆☆Clinical Trial Registration Number: NCT01799252.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
