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Infectious Diseases in Obstetrics and Gynecology
Volume 3, Issue 4, Pages 158-163
Clinical Study

Randomized, Double-blinded, Placebo-controlled Trial of Amoxicillin/Clavulanic Acid to Prevent Preterm Delivery in Twin Gestation

1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
2Department of Academic Computing, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
3Department of Obstetrics and Gynecology , 319 West, 1600 South Andrews Avenue, Fort Lauderdale 33316, FL, USA

Received 19 April 1995; Accepted 6 September 1995

Copyright © 1995 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective: The objective of this study was to determine whether prophylactic treatment with oral broad-spectrum antimicrobial therapy improves pregnancy outcomes in twin gestations.

Methods: Patients with twin gestations between 24 and 32 weeks were randomized to receive amoxicillin/clavulanic acid or placebo. Those patients randomized before 24 weeks received a 1-week course at 24 and at 28 weeks gestation. Those patients entered later than 24 weeks received a 1-week course either at 28 weeks or at enrollment (up to 32 weeks). Other than antibiotic use, the management of the groups was identical and unchanged from the routine care of twin gestations.

Results: Of 149 twin pregnancies enrolled, 76 were randomized to the drug group and 73 to the placebo group. There was no significant difference in mean gestational age at delivery (35.9 vs. 35.7 weeks), birth weight (2,358 vs. 2,344 g), mean neonatal nursery stay (9.9 vs. 11.7 days), or respiratory distress syndrome (6/76 vs. 4/73) in the drug vs. placebo group, respectively.

Conclusions: The addition of prophylactic oral broad-spectrum antimicrobial therapy to the standard antepartum management of twin gestations had no demonstrable effect on the gestational age at delivery, birth weight, or neonatal complications. There did not appear to be any beneficial effect of the prophylactic use of amoxicillin/clavulanic acid in this clinical setting.