Community-generated resource library-Rates of Serious Infection after Changes in Regimens for Medical Abortion

Rates of Serious Infection after Changes in Regimens for Medical Abortion

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The study published in the New England Journal of Medicine explored the impact of changes in medical abortion protocols on rates of serious infection. Conducted by a team including Mary Fjerstad and colleagues across institutions like the Planned Parenthood Federation of America and Northwestern University, the research involved a retrospective analysis of medical abortion procedures from 2001 to 2008.<br /><br />Initially, Planned Parenthood in the United States administered medical abortions using oral mifepristone followed by vaginal misoprostol. Concerns about serious infections prompted changes in 2006, switching to buccal administration of misoprostol and introducing either routine antibiotics or screening for chlamydia followed by treatment. By July 2007, routine antibiotics were required for all medical abortions.<br /><br />The analysis covered 227,823 women, revealing a significant drop in serious infection rates following these changes. The infection rate fell by 93%, from 0.93 per 1,000 abortions to 0.06 per 1,000 after these interventions were implemented. The shift to buccal misoprostol and the subsequent introduction of routine antibiotics were associated with substantial declines in infection rates. Notably, routine antibiotic administration was found to be more effective than the screen-and-treat approach.<br /><br />This study indicates that changes in the administration method of misoprostol and infection prevention strategies notably reduced serious infections post-abortion. It validates the benefits of prophylactic antibiotics in medical abortions, despite previously insufficient data to recommend their routine use. The findings underscore the importance of antibiotic administration in reducing post-abortion infections, particularly in contrast with Europe's differing outcomes potentially due to different practices. The study highlights the need for adaptations in medical protocols to enhance patient safety.

Keywords

medical abortion

serious infection

misoprostol administration

prophylactic antibiotics

infection prevention

Planned Parenthood

retrospective analysis

post-abortion infections

patient safety

New England Journal of Medicine