bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of 3‐Day Course of Doxycycline for the Treatment of Uncomplicated Chlamydia trachomatis Cervicitis
Authors: Reedy Mark B. , Sulak Patricia J. , Miller Sally L. , Ortiz Miriam , Kasberg-Preece Cheryl , Kuehl Thomas J. 
Published: March 2007

Objective: The purpose of this study was to compare the efficacy of a 3‐day course of doxycycline to a standard 7‐day course for treating uncomplicated chlamydia cervicitis.Methods: During an 18‐month period, 77 women with uncomplicated chlamydia cervicitis were randomized to receive either a 3‐day or a 7‐day course of doxycycline (100 mg twice daily). Tests of cure were performed 3 weeks after completion of therapy with the Amplicor polymerase chain reaction (PCR) assay (Roche Molecular Systems, Branchburg, NJ). Demographics, therapeutic results, and side effects for the two groups were compared.Results: Seventy‐three patients completed the study: 35 in the 3‐day group and 38 in the 7‐day group. There were no significant differences in age, gravidity, or parity between the groups. There was a 94% (33/35) cure rate in the 3‐day group and a 95% (36/38) cure rate in the 7‐day group (P = 1.0). Thirty‐four percent and 32% of the patients in the 3‐ and 7‐day groups reported side effects, respectively; there was no significant differences between the 3‐ and 7‐day groups in regard to population demographics, patient compliance, therapeutic outcome, or side effects.Conclusions: A 3‐day course of doxycycline appears to be as effective as a 7‐day course of doxycycline for the treatment of uncomplicated chlamydia cervicitis.
Phage Infection in Vaginal Lactobacilli: An In Vitro Study
Authors: Pavlova Sylvia I. , Kiliç Ali O. , Mou Susan M. , Tao Lin 
Published: March 2007

Objective: During bacterial vaginosis, an unexplained decrease of vaginal lactobacilli occurs. To identify whether these lactobacilli could be infected by phages, we isolated phages from vaginal lactobacilli and analyzed their potential virulence in attacking vaginal lactobacilli in vitro.Methods: Vaginal samples were obtained from 39 reproductive‐aged women. The selective Rogosa SL agar was used to isolate lactobacilli, from which phages induced by mitomycin C or released spontaneoulsy were analyzed by the agar spot method.Results: Of 20 samples from women with vaginal infections, 12 did not have lactobacilli. From the remaining 8 infection samples and the 19 samples from healthy women, 37 Lactobacillus strains were isolated, from which 7 temperate phages were identified. Upon analysis, all 7 phages infected vaginal lactobacilli from the same and/or different women in vitro. Two phages, Φkc005 and Φkc007, had a broad host range, infecting 7 of 8 species tested. A control intestinal Lactobacillus phage also lysed several vaginal strains. One vaginal phage, Φkc039, was apparently lytic against vaginal lactobacilli from 7 other women. This phage was characterized as follows: plaque morphology, small and clear; burst size, 300 phages per cell; spontaneous induction rate, 1 per 106 cells; DNA, double‐stranded and linear, 41 kb; and shape, a hexogonal head and a non‐contractile tail.Conclusions: Bacteriophages were isolated from vaginal lactobacilli of some women and were shown in vitro to lyse vaginal Lactobacillus strains from the same and/or different women. It was suggested that vaginal lactobacilli might be suppressed by phages.
Open Study of the Safety and Efficacy of a Single Oral Dose of Cefixime for the Treatment ofGonorrhea in Pregnancy
Authors: Miller Joseph M. 
Published: March 2007

Objective: The intent of this study was to determine the efficacy and tolerance of single dose oral cefixime use in the treatment of pregnant women with endocervical gonococcal carriage.Methods: A retrospective review of clinic records over a 3 year period identified patients treated with a single 400 mg dose of cefixime for gonorrhea during pregnancy. Side effects and subsequent gonococcal carriage were noted.Results: Pregnant women (n = 102) treated with cefixime were reviewed. A cure rate of 95.2% was found. Side effects were reported in three patients: two had nausea and vomiting and one had diarrhea.Conclusions: A single 400 mg oral dose of cefixime was effective for the treatment of gonorrhea and was well tolerated by the pregnant women.
Double‐Blind, Multicenter, Prospective Randomized Study of Trospectomycin Vs. Clindamycin, Both With Aztreonam, in Non‐Community Acquired Obstetric and Gynecologic Infections
Authors: Chatwani Ashwin , Martens Mark , Blanco Jorge , Gall Stanley , Przybylko Kira , Wajszczuk Charles P. , Nickens Dana 
Published: March 2007

Objective: The purpose of this study was to compare the clinical efficacy and safety of trospectomycin sulfate with that of clindamycin phosphate, both with aztreonam, for the treatment of obstetric and gynecologic infections.Methods: In a double‐blind, multicenter, prospective randomized study, 579 patients with either endometritis following cesarean delivery or pelvic cellulitis following hysterectomy were enrolled and received medication. Administered was either trospectomycin sulfate 500 mg IV every 8 h or clindamycin phosphate 900 mg IV every 8 h in a 1:1 randomization ratio. Both groups of patients received aztreonam 1 g IV every 8 h. The patients were followed for clinical responses and side effects.Results: The cure rate for the trospectomycin sulfate arm was 91.8% and for clindamycin phosphate arm it was 88.4% (P = 0.218). The adverse events were similar in both groups.Conclusions: Trospectomycin was as effective as clindamycin, when both were combined with aztreonam, in treatment of obstetric and gynecologic infections.
Maternal Death From Postpartum Necrotizing Fasciitis Arising in an Episiotomy: A Case Report
Authors: Lynch Catherine M. , Pinelli Donna M. , Cruse C. Wayne , Spellacy William N. , Sinnott John T. , Shashy Ron G. 
Published: March 2007

Background: Necrotizing fasciitis is a rare condition. We report a fatal case arising from an episiotomy in a previously healthy woman.Case: A healthy 23‐year‐old prima gravida white female underwent vaginal delivery with repair of a proctoepisiotomy. Eighty‐four hours postpartum, she developed increasing perineal swelling with severe pain. She presented on the 4th postpartum day with edema, erythema localized to the perineum, and vital signs significant only for tachycardia of 120/min. With a leukocytosis of 45,000/μl (87%) neutrophils, she was admitted to the hospital with an initial diagnosis of perineal cellulitis and empirically started on broad‐spectrum intravenous antibiotic therapy. The patient′s condition continued to deteriorate and she was then transferred to our facility on postpartum day 9 where a team performed two radical debridements of all necrotic tissue. Despite this and a broadened antibiotic coverage, the patient eventually experienced cardiopulmonary arrest and died on postpartum day 12.Conclusion: Necrotizing fasciitis must be considered in the differential diagnosis of the postpartum patient presenting with severe vulvar pain and erythema. Our patient exemplifies the obscure presentation with seemingly minimal skin changes. Any delay in diagnosis and treatment, which must include expeditious aggressive surgical debridement, will likely result in severe morbidity or mortality.
Detection of Antibodies to Chlamydia trachomatis With Peptide‐Based Species‐SpecificEnzyme Immunoassay
Authors: Närvänen Ale , Puolakkainen Mirja , Hao Wu , Kino Kohsuke , Suni Jukka 
Published: March 2007

Objective: We have evaluated the sensitivity and specificity of a new synthetic peptide‐based species‐specific enzyme immunoassay (EIA) for detection of Chlamydia trachomatis IgG and IgA antibodies.Methods: Synthetic peptides derived from variable domain IV of major outer membrane protein (MOMP) were used as antigen in indirect EIA. IgG and IgA antibodies were measured in parallel with serum samples from C. trachomatis culture positive, culture negative, and antigen positive patients, and women with suspected C. trachomatis infection and blood donors. Sera from children under 15 years of age were used as controls.Results: Culture positive women, culture positive men, and antigen positive women had positive peptide serology in 84.2%, 61.3%, and 93.1% of the cases, respectively. Among C. trachomatis suspected women, the antibody prevalence was 63.6%. Randomly collected blood donors showed a prevalence of 21.5%. Children with C. pneumoniae antibodies determined with the microimmuno‐fluorescence (MIF) method did not show any reactivity in the C. trachomatis peptide EIA.Conclusions: The results suggest that the new EIA test is highly specific for C. trachomatis, and C. pneumoniae antibodies do not interfere. Both IgG and IgA antibodies appear within at least 2 weeks in acute phase of infection among both culture positive and culture negative patients.
Evaluation of Specific Symptoms of Bacterial Vaginosis Among Pregnant Women
Authors: Boris J. , Henriksen T. B. , Davidsen U. , Secher N. J. 
Published: March 2007

Objective: Identification of the symptoms of bacterial vaginosis (BV) in pregnancy might be rational in order to identify a possible BV‐associated group at risk of preterm delivery.Methods: Three hundred and five women early in the third trimester of pregnancy were interviewed about lifestyle factors and specific symptoms of BV and given a vaginal examination. A longitudinal three‐week follow‐up was conducted for 127 women.Results: The prevalence of BV was 16%. Women with BV were significantly more often smokers than women without BV (52% vs. 34%). No difference in sexual activity or other behavioral characteristics between the two groups were seen. No differences were noted among women with and without BV according to specific symptoms: malodorous discharge (26% vs. 23%), increased discharge (76% vs. 68%), or itching or troublesome discharge. More than one third of women with BV at the first examination did not fulfill the criteria for BV at the three week follow‐up exam. None of the women without BV had developed BV by the follow‐up exam. The incidence of preterm delivery among women with BV was 4%, women without BV had an incidence of 2.4%. This difference was not statistically significant.Conclusion: Asymptomatic BV in pregnancy is common. Specific questions about the character of the discharge do not identify women with BV during pregnancy. To identify a potential BV‐associated group at risk for preterm delivery, screening for BV must be conducted not only among symptomatic women but among all women. Women with BV are more often smokers than women without BV.
Grepafloxacin Versus Cefixime as Single‐Dose Therapy for Uncomplicated Gonorrhea in Women
Authors: Mroczkowski T. F. , Hook E. W. , Jones R. B. , McCormack W. M. , Martin D. H. 
Published: March 2007

Objective: To compare the efficacy and tolerance of single‐dose grepafloxacin with cefixime for treatment of uncomplicated gonorrhea in women.Methods: Women attending nine sexually‐transmitted‐disease clinics in the United States who had suspected uncomplicated gonorrhea were enrolled in an open study. Participants were randomized to receive single oral doses of grepafloxacin (400 mg) or cefixime (400 mg), and efficacy was evaluated in those who returned for follow‐up assessment 5 to 10 days later. The primary measure of efficacy was microbiological response to therapy as determined by pre‐ and posttreatment culture results for Neisseria gonorrhoeae.
Results: Of 380 patients enrolled, 124 in the grepafloxacin group and 131 in the cefixime group were evaluated for microbiological response. Cervical gonococcal infections were eradicated in 99% of patients in both treatment groups, with only one persistent infection in each group. All pharyngeal (n = 15) and rectal (n = 32) gonococcal infections treated with grepafloxacin were cured, whereas 5 of 16 (31%) pharyngeal and 1 of 38 (3%) rectal infections failed to respond to cefixime. Although a third (123 of 386) of N. gonorrhoeae pretreatment isolates were resistant to penicillin or tetracycline, this had no impact on cure rates. Both drugs were well tolerated, with vaginitis being the most common treatment‐related adverse event in each group.Conclusions: This study shows that single‐dose grepafloxacin is at least as effective as cefixime for treating women with uncomplicated cervical gonorrhea. Grepafloxacin also appears to be highly effective against extragenital infections.
Expanding Disease Spectrum Associated With Puerperal Mastitis
Authors: McAdoo Gregg L. , Monif Gilles R. G. 
Published: March 2007

Background: Staphylococcus aureus and the β‐hemolytic streptococci are the commonest causes of puerperal mastitis which tends to be a localized disease process. This report describes 2 cases attributable to these bacteria that resulted in extramammary involvement and augmented morbidity.Cases: Two cases of postpartum mastitis are described, one leading to necrotizing fasciitis caused by group A streptococci and the other leading to toxic shock syndrome (TSS) caused by S. aureus.Conclusion: The spectrum of disease commonly attributed to mastitis occurring in this setting should be expanded.
Vertical Transmission of Herpes Simplex Virus Acquired After Primary Outbreak in SecondTrimester of a Dichorionic Twin Gestation
Authors: Joffe G. M. , Olson K. , Merlin T. L. , Brown A. 
Published: March 2007

Background: The incidence of genital herpes simplex virus (HSV) has increased in recent years, particularly among women of reproductive age. This places more neonates at risk for severe morbidity and mortality. Treatment recommendations for primary disease in pregnancy are lacking, particularly for those who acquire. HSV remote from term.Case: A patient at 17 weeks of gestation carrying dichorionic twins developed primary herpes with subsequent vertical transmission of the virus and significant neonatal morbidity.Conclusion: Data regarding risks and benefits of treatments such as acyclovir and immunoprophylaxis are lacking at a time when the incidence of HSV infection is on the rise.
Female Genital Tract Bacterial Coisolates WithCandida albicans in Patients Without Clinical Vaginitis
Authors: Monif G. R. G. , Carson H. J. 
Published: March 2007

Objective: In vitro, Candida albicans has demonstrated the ability to inhibit replication of selected
bacteria. Little information exists on the impact of C. albicans on the vaginal bacterial flora in vivo.
The purpose of this study is to identify the coexisting bacterial flora when C. albicans is isolated from
vaginal cultures submitted to a hospital‐based testing facility for reasons other than vulvovaginitis.Methodology: All specimens (240) received from ambulatory care clinics over a six‐month period
were cultured for aerobic and anaerobic bacteria and Candida species. Those specimens submitted
for cervicitis, vaginitis, or vaginal discharge and those from which yeasts other than C. albicans
were isolated were eliminated. To control for sample biases, a subgroup composed of all pregnant
women for whom cultures were done as screening procedures was similarly studied. Chi‐square
analyses, comparing the prevalence of individual bacteria isolated with and without the presence of
C. albicans, were done for all study populations using SPSS for Windows software (1994).Results: Two hundred and forty consecutive specimens were bacteriologically analyzed. Of the
220 vaginal samples used in the study, C. albicans was isolated in 44 instances (20%). Neither the
presence of the lactobacilli nor the presence of Gardnerella vaginalis markedly influenced the isolation
rate of C. albicans. The group B streptococci had a greater probability of coisolation when
C. albicans was present (27.3%) verses 16%), but this was not statistically significant (P < 0.8).
Dissociation between the presence of C. albicans and the coisolation of Peptostreptococcus species
and anaerobic gram‐positive cocci and/or bacilli was noted (P < 0.0819). while the incidence of
gram‐positive aerobic bacilli was reduced in the presence of C. albicans (30/176 [17.1%] versus 6/44
[13.6%]), this reduced incidence was not statistically significant. Isolation data of the subgroup of
pregnant women supported these observations.Conclusion: Within the limitations of the study, statistically, the data suggests that an inverse
relationship exists between the presence of C. albicans and recovery of Peptostreptococcus and anaerobic
gram‐positive cocci and bacilli.
A Comparison of Ligase Chain Reaction toPolymerase Chain Reaction in the Detection ofChlamydia trachomatis Endocervical Infections
Authors: Davis J. D. , Riley P. K. , Peters C. W. , Rand K. H. 
Published: March 2007

Objective: To compare the reliability of ligase chain reaction (LCR) to polymerase chain
reaction (PCR) in detecting Chlamydia trachomatis endocervical infections.Methods: We conducted a prospective study of 486 patients at risk for chlamydial infection of the
endocervix. We obtained two endocervical specimens from each patient and used LCR and PCR to
detect C. trachomatis. Discrepant results between the two techniques were resolved by repeat testing
and by testing for the major outer membrane protein (MOMP) gene, if necessary. We determined
the sensitivity, specificity, positive predictive value, and negative predictive value for each test, using
concordant results or MOMP gene results as the “gold standard”.Results: Of the 486 patients, 42 (8.6%) had evidence of C. trachomatis infection after resolution of
discrepant results. Of the 42 true positive specimens, 41 were positive by initial LCR and 38 were
positive by initial PCR. Of the 444 true negative specimens, none had a positive initial LCR result,
while 2 had a positive initial PCR test. Therefore, compared to the gold standard, LCR had a
sensitivity of 97.6% and specificity of 100%, while PCR had a sensitivity of 90% and a specificity of
99.5%. The positive and negative predictive values of LCR were 100% and 99.8%, respectively.
PCR had a positive predictive value of 95% and a negative predictive value of 99.1%. The difference
in sensitivity of LCR versus PCR was not statistically significant (P = .125).Conclusion: LCR and PCR perform equally well in detecting C. trachomatis endocervical infections.
Studies on the Pathogenicity of Anaerobes, EspeciallyPrevotella bivia, in a Rat Pyometra Model
Authors: Mikamo H. , Kawazoe K. , Izumi K. , Watanabe K. , Ueno K. , Tamaya T. 
Published: March 2007

Objective: Prevotella bivia is one of the anaerobic bacteria that resides in the flora of the female
genital tract. We studied the pathogenicity of P. bivia in a rat pyometra model.Methods: The experimental animial (rat) model of pyometra was developed to investigate the
pathogenicity of P. bivia in a rat pyometra model.Results: In the groups inoculated with aerobes alone, the infection rate was 10% (1/10) in the
Staphylococcus aureus‐ or Staphylococcus agalactiae ‐inoculated group and 20% (2/10) in the
Escherichia coli‐inoculated group. Infection Was not established in the groups inoculated with anaerobes
alone. High infection rates were observed in all the mixed‐infection groups. In the S. agalactiae‐ and
Bacteroides fragilis‐, S. agalactiae‐ and P. bivia -, E. coli-
and B. fragilis‐, and E. coli‐ and P. biviai‐ inoculated
groups, an infection rate of 100% (10/10) was demonstrated. The efficacy of antibiotics
such as flomoxef (FMOX) could be determined using a rat pyometra model. In relation to the
alteration of vaginal microbial flora during the menstrual cycle, estrogen increased the growth of P. bivia.Conclusion: Mixture of aerobic bacteria and P. bivia increased the pathogenicity of P. bivia.
Estrogen would be useful for raising up the inflammatory change of the uterus in experimental
models of genital tract infection due to P. bivia.
Daily Oral Grepafloxacin vs. Twice Daily OralDoxycycline in the Treatment of Chlamydia trachomatisEndocervical Infection
Authors: McCormack W. M. , Martin D. H. , Hook E. W. , Jones R. B. 
Published: March 2007

Objective: To compare the efficacy and safety of a 7‐day course of treatment with oral grepafloxacin,
400 mg once daily, and oral doxycycline, 100 mg twice daily, in patients with chlamydial cervicitis.Methods: Women aged 18 years or older attending 17 sexually transmitted disease clinics in the
United States who had clinical signs of mucopurulent cervicitis or who had a recent positive culture
or nonculture test for Chlamydia trachomatis or who had contact with a male partner with a positive
culture for C. trachomatis were enrolled into this randomized, double‐blind, active‐controlled clinical
study. The diagnosis of chlamydial cervicitis was based on culture for C. trachomatis. Patients were
randomized to receive a 7‐day course of treatment with either oral grepafloxacin, 400 mg once daily,
or oral doxycycline, 100 mg twice daily. Response to therapy was assessed 3–8 days and 21–28 days
after completion of treatment. The primary measure of efficacy was eradication of C. trachomatis at
the 21–28 day follow‐up visit. Clinical success, defined as improvement or complete resolution of the
signs and symptoms of cervicitis, was a secondary measure of efficacy.Results: Of the 451 female patients enrolled, 228 received grepafloxacin and 223 received doxycycline.
In all, 154/451 (35%) patients were evaluable at the 21–28 day follow‐up (81 who received
grepafloxacin and 73 who received doxycycline). Microbiologic and clinical success rates demonstrated
the equivalence of the two treatments. The C. trachomatis eradication rates were 96.3%
(78/81) and 98.6% (72/73) for patients receiving grepafloxacin or doxycycline, respectively. The two
study drugs were also equivalent in resolving clinical signs and symptoms, with clinical success
rates of 88.9% (64/72) and 89.5% (51/57) for patients treated with grepafloxacin and doxycycline,
respectively. Both drugs were well tolerated, with 47% of patients receiving grepafloxacin and 46%
of patients receiving doxycycline experiencing drug‐related adverse events, none of which was
serious.Conclusions: Seven days of treatment with oral grepafloxacin, 400 mg once daily, was as effective
as 7 days of treatment with oral doxycycline, 100 mg twice daily, in patients with cervicitis caused
by C. trachomatis. Both agents were well tolerated and had comparable safety profiles. Grepafloxacin’s
once‐daily dosing regimen may offer advantages in terms of patient compliance.
The Pharmacokinetics of Once‐Daily Dosing WithGentamicin in Women WithPostpartum Endometritis
Authors: Sunyecz J. A. , Wiesenfeld H. C. , Heine R. P. 
Published: March 2007

Objective: To evaluate the pharmacokinetics and cost of once‐daily dosing with gentamicin in
women with postpartum endometritis.Methods: Gentamicin in a single daily dose of 4.5 mg/kg was administered intravenously to10
women with postpartum endometritis. Peak and trough gentamicin levels were measured, and
nephrotoxicity and clinical ototoxicity were monitored. Pharmacokinetic data were analyzed, and
a cost analysis of once‐daily gentamicin administration was performed.Results: The mean elimination conslant was 0.105 ± 0.008 L/h, and the mean volume of distribution
was 0.34 ± 0.07 L/kg. Mean peak gentamicin levels exceeded 11 mg/L, and all trough levels
were <0.3 mg/L. Cost savings of 44% were achieved with once‐daily dosing of gentamicin, compared
with traditional thrice‐daily dosing.Conclusions: Once‐daily dosing with gentamicin in women with postpartum endometritis achieves
therapeutic peak levels without drug accumulation. Substantial cost savings are realized with this
dosing regimen.