Effectiveness of Parenteral Antibiotics Alone in Uncomplicated Septic Abortion After Evacuation Dr. Nu Nu Htwe Specialist Assistant Surgeon Department of Obstetrics and Gynaecology University of Medicine Mandalay

Objective To compare the outcomes of women with uncomplicated septic abortion with or without continuation of oral antibiotics after evacuation and parenteral antibiotics

Materials and Method It was a randomized double blind study conducted in Central Women’s Hospital (CWH), Mandalay from January 2015 to December 2015. Seventy four women with uncomplicated septic abortion admitted to gynaecological units were included in this study.

Uncomplicated septic abortion was diagnosed by using clinical criteria and treated with evacuation and parenteral antibiotics (Ciprofloxacin and Metronidazole) until 48 hours after clinical improvement. Thirty seven patients were treated with oral placebos and thirty seven patients were treated with oral antibiotics. All the women were followed up 7 days after oral treatments.

Results Clinical cure which was defined as the absence of fever, no vaginal bleeding, no pelvic pain, no hospital readmission and no additional medication. The clinical cure rate was 97.3% for both oral placebo group and oral antibiotic group. Clinical failure was defined as presence of fever with one out of four criteria such as no reduction of vaginal bleeding, persistence of pelvic pain, hospital readmission or the need to use additional medication.

Clinical failure rate was 2 Clinical failure rate was 2.7% for both oral placebo group and oral antibiotic group. There was no statistical significant difference between placebos and oral antibiotics after evacuation and parenteral antibiotics until 48 hours of clinical improvement in uncomplicated septic abortion cases.

Conclusion In the management of uncomplicated septic abortion cases, parenteral antibiotics alone after evacuation was found to be effective. It was found that placebo arm was not associated with adverse events like need of hospital readmission, requirement of additional medicines during follow up.

Therefore parenteral antibiotics alone in uncomplicated septic abortion after evacuation could be used as a safe treatment option avoiding the side effects and additional costs of oral antibiotics.