The effectiveness of antibiotic treatment at reducing post-abortion infection is unclear. The experiences of women prescribed routine antibiotics after medical abortion is missing from the existing evidence. This study seeks to add to the literature evidence of the side effects associated with antibiotic treatment that women experience and their adherence to prescribed regimens.
Medical abortion (MA) consists of administering medication, typically a combination of mifepristone and misoprostol, to induce an abortion without any invasive procedures. Early first trimester MA is effective1, highly acceptable to women, and safe. The risk of infection following medical abortion is small, at less than 1%. In rare circumstances, pelvic infection with clostridia bacteria following medical abortion has resulted in death. Since 2000, when mifepristone was registered in the United States, 8 such deaths have been recorded in the US. Following the publication of case reports of four clostridium-associated deaths after medical abortion in 2005, the reproductive health community reacted swiftly. Medical abortion protocols were altered in an effort to curb these drastic and rapidly fatal infections. Antibiotic treatment, typically a seven-day course of doxycycline, has become widespread in the United States. The effectiveness of antibiotic treatment at reducing post-abortion infection is unclear. The experiences of women prescribed routine antibiotics after medical abortion is missing from the existing evidence. This study seeks to add to the literature evidence of the side effects associated with antibiotic treatment that women experience and their adherence to prescribed regimens.
Study Type
OBSERVATIONAL
Enrollment
582
Feminist Women's Health Center
Atlanta, Georgia, United States
Family Planning Associates
Chicago, Illinois, United States
Planned Parenthood Mid and South Michigan
Ann Arbor, Michigan, United States
Planned Parenthood MN, ND, SD
Saint Paul, Minnesota, United States
Incidence rates of nausea
Compare the incidence rates of nausea between women who are prescribed a seven-day regimen of doxycycline to women who are not prescribed antibiotics following medical abortion
Time frame: 7-14 days following medical abortion
adherence
Document the self-reported adherence to antibiotic regimens following medical abortion
Time frame: 7-14 days following medical abortion
Nausea rates
Compare the rates of nausea between women who take at least one doxycycline pill to women who do not take any doxycycline following medical abortion
Time frame: 7-14 days following medical abortion
Non-nausea side effects
Compare the rates of other (non-nausea) side effects between women who are prescribed a seven-day regimen of doxycycline to women who are not prescribed antibiotics following medical abortion
Time frame: 7-14 days following medical abortion
Additional medications
Compare the use of additional medication to treat side effects between women who take antibiotics and women who do not take antibiotics following medical abortion
Time frame: 7-14 days following medical abortion
Cost
Document the cost to women of antibiotics regimens following medical abortion
Time frame: at time of filling prescription
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Family Practice and Sidney Hillman Family Practice at the Institute for Family Health
New York, New York, United States
NYU/Bellevue Hospital Center, Women's Health Center
New York, New York, United States
Cedar River Clinic
Renton, Washington, United States