Prevention of Very Preterm Delivery by Testing for and Treatment of Bacterial Vaginosis (PREMEVA)
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Purpose
Background. Anomalies of the vaginal flora (bacterial vaginosis, BV) are associated with an increased risk of late abortions and preterm birth. Studies of antibiotic treatment of BV to reduce the risk of prematurity have not found a statistically significant diminution of risk (<= 32 wks: OR=0.49 [0.05-5.1], < 37 wks: OR=0.83 [0.59-1.17]).A partial explanation of these findings is that some of these treatment were administered vaginally, most often during the second or third trimester
Aim: To reduce the frequency of late abortions and very preterm birth by prescribing clindamycin vs placebo to patients diagnosed with BV before 13 weeks.
| Condition | Intervention | Phase |
|---|---|---|
|
Pregnancy |
Drug: Clindamycin Drug: Placebo |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Randomized Multicenter Trial for the Prevention of Preterm Delivery by Testing for and Treatment of Bacterial Vaginosis in the First Trimester of Pregnancy |
- Premature delivery (16 to 32 weeks of gestation) [ Time Frame: At delivery ] [ Designated as safety issue: Yes ]
- Preterm labor, PPROM, Spontaneous preterm labor, PROM, Abruptio placentae, Chorioamnionitis, Fever > 38°C during labor, Post partum fever (> 38°), Post-partum wound infections, Perinatal death, NICU transfer, Bacterial neonatal colonisation. [ Time Frame: At delivery ] [ Designated as safety issue: Yes ]
| Enrollment: | 3105 |
| Study Start Date: | April 2006 |
| Study Completion Date: | June 2011 |
| Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Clindamycin Cure 1
Arm 1
|
Drug: Clindamycin
300 mg capsules (per os) Intervention= 2 capsules/d during 4 days: three times a month apart
Other Name: non applicable
|
|
Active Comparator: Clindamycin Cure 2
Arm 2
|
Drug: Clindamycin
300 mg capsules (per os) Intervention= 2 capsules/d during 4 days: one time and then, after one month placebo capsules 2 capsules/d during 4 days: two times a month apart
Other Name: non applicable
|
|
Placebo Comparator: Placebo
Arm placebo
|
Drug: Placebo
Double blinded capsules(per os) Intervention= 2 capsules/d during 4 days: three times a month apart
Other Name: non applicable
|
Detailed Description:
Patients diagnosed with BV before 13 weeks will be divided into two groups. They will be defined as at low risk when they have no history of spontaneous preterm delivery or late abortion. Women with such histories will be defined as at high risk.
Low risk patients will be asked to participate in a trial with 3 equal parallel groups, comparing two regimes of clindamycin (one or three 4-day treatments of clindamycin 300 mgx2/d) and placebo.
High-risk patients will be asked to participate in a trial with 2 parallel groups to assess the usefulness of repeating antibiotic treatment monthly by comparing the administration of one 4-day treatment of clindamycin (300 mgx2/d) to three 4-day treatments, one month apart.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Nugent score >= 7
- pregnant women < 15 weeks (strictly)
- signed informed consent
- >=18 old
- speaking and understanding French language
Exclusion Criteria:
- metrorrhagias during 7 days before
- birth anticipated in an other area
- clindamycin allergy
Contacts and Locations| France | |
| Hopital Jeanne de Flandre | |
| Lille, France, 59 000 | |
| Principal Investigator: | Damien SUBTIL, MD PhD | University Hospital, Lille (France) |
| Study Chair: | Gilles Brabant, MD | Groupe Hospitalier de l' Institut Catholique, Lille |
More Information
Additional Information:
No publications provided
| Responsible Party: | University Hospital, Lille |
| ClinicalTrials.gov Identifier: | NCT00642980 History of Changes |
| Other Study ID Numbers: | 060216, PHRC 2004/1918, PHRC 2008/1929, 2004/0428 |
| Study First Received: | March 21, 2008 |
| Last Updated: | June 12, 2013 |
| Health Authority: | France: National Consultative Ethics Committee for Health and Life Sciences France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) France: Ministry of Health |
Keywords provided by University Hospital, Lille:
|
Pregnancy Preterm delivery Bacterial vaginosis Randomized Clinical Trial Clindamycin |
Additional relevant MeSH terms:
|
Vaginosis, Bacterial Premature Birth Bacterial Infections Vaginitis Vaginal Diseases Genital Diseases, Female Obstetric Labor, Premature Obstetric Labor Complications Pregnancy Complications |
Clindamycin Clindamycin-2-phosphate Protein Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 18, 2013