Original research article| Volume 91, ISSUE 1, P19-24, January 2015

What happens when we routinely give doxycycline to medical abortion patients?

  • Laura J. Frye
    Corresponding author at: Gynuity Health Projects, 15 East 26th Street, Suite 801, New York, NY 10010. Tel.: +1 212 448 1230; fax: +1 212 448 1260.
    Gynuity Health Projects, New York, NY 10010, USA
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  • Erica Chong
    Gynuity Health Projects, New York, NY 10010, USA
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  • Beverly Winikoff
    Gynuity Health Projects, New York, NY 10010, USA
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  • NCT01799252 Trial Investigators
    Author Footnotes
    1 Dr. Carol Ball, Dr. Lisa Harris, Dr. E. Steve Lichtenberg, Dr. Jules Marsh, Dr. Tamer Middleton, Dr. Amitasrigowri Murthy, Dr. Linda Prine.
  • Author Footnotes
    1 Dr. Carol Ball, Dr. Lisa Harris, Dr. E. Steve Lichtenberg, Dr. Jules Marsh, Dr. Tamer Middleton, Dr. Amitasrigowri Murthy, Dr. Linda Prine.



      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).


      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.


      Women who were prescribed doxycycline following medical abortion reported moderate adherence and experienced significantly more vomiting than their counterparts.


      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.


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