Peroperative penicillins, bacteremia, and pelvic inflammatory disease in association with induced first-trimester abortion.

In a clinical, controlled trial including 474 women, 250 were randomised to prophylactic treatment with penicillin/pivampicillin and 224 to placebo treatment. Cervical, uterine, and blood cultures were obtained at abortion. In the treatment group, 13 percent developed bacteremia versus 14 percent in the placebo group. The distribution of species cultured from the cervix and uterus was not significantly different from that of the species recovered in the blood. A previous report found that women with a history of pelvic inflammatory disease (PID) carried a higher risk of contracting postabortal genital infection. However, the frequency of bacteremia in these women was not significantly different from the frequency in women without previous PID (p greater than 0.3). In women with and without postabortal infection, no significant differences were observed between the frequencies of bacteremia, either in the antibiotic group (p greater than 0.9) or in the placebo group (p greater than 0.7), suggesting that the release of bacteria into the blood stream from the instrumented tissues is without pathogenetic importance in postabortal infection.