Oral Antibiotics After Obstetric Perineal Tear

NCT ID: NCT05830162

Last Updated: 2024-12-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

442 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-21

Study Completion Date

2024-12-09

Brief Summary

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The purpose of this study is to investigate if 3 dose of oral antibiotics administrated the first day after a vaginal delivery with a second degree obstetric tear will decrease the risk of infection and/or wound dehiscence compared to women with 3 doses of placebo treatment.

Detailed Description

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Background:

Obstetric tear occurs in more than 90% of nulliparous women and up to 25% subsequently experience wound dehiscence and/or infection. Some data shows that intravenous antibiotics given during delivery reduces this risk. It is unknown if oral antibiotics given after delivery can reduce the risk of wound dehiscence or infection.

The study-goupe want to investigate whether three doses of antibiotics (amoxicillin 500 mg / clavulanic acid 125 mg) given after delivery can reduce the risk of wound dehiscence and infection.

Methods:

The investigators will perform a randomized, controlled, double-blinded study and plan to include 221 women in each arm with allocation 1:1 in relation to the randomization. The study is carried out at Department of Obstetrics \& Gynecology, Herlev University Hospital, Copenhagen, Denmark. The women will be included after delivery if they have had a second-degree tear or episiotomy. The first tabelt has to be taken with in 6 hours from the delivery. After inclusion, the women will have a clinical follow up visit after one week. The tear and healing will be evaluated regarding infection and/or dehiscence. The women will again be invited for a one year clinical examination including ultrasound. Questionaries exploring symptoms related to the vaginal tear and possible complications will be answered at both visits.

The primary outcome is wound dehiscence and/or wound infection, which will be calculated using χ2-tests to compare groups. Secondary outcomes are variables that relate to wound healing, for example pain, use of painkillers, need for further follow-up, as well as other outcomes that may be related to the birth or healing process; urinary or anal incontinence, symptoms of prolapse, female body image and sexual problems.

Discussion:

Reducing the risk of wound dehiscence and/or infection would decrease the number of control visits, prevent the need for longer antibiotic treatment and possibly also decrease both short-term and long-term symptoms. This would be of great importance since the period after a delivery is a crucial time for the whole family.

Conditions

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Obstetric Trauma Infections Wound Dehiscence

Keywords

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obstetric tear women's health antibiotics infection wound dehiscence

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Placebo

The Pharmacy of the main capital region provides the bioclavid (amoxicillin with Clavulanic acid) and placebo tablets for this study. They are responsible for the randomization and packing of the tablets. The randomization will be in randomly variating block sizes.

Women in the placebo arm will get 3 calcium tablets to take within the fist 24 hours of the delivery. The first tablet must be administrated within 6 hours of the delivery.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

We will evaluate how many women gets an infection and/or wound dehiscence after a second degree obstetric tear or episiotomy

Antibiotics (bioclavid)

The Pharmacy of the main capital region provides the bioclavid (amoxicillin with Clavulanic acid) and placebo tablets for this study. They are responsible for the randomization and packing of the tablets. The randomization will be in randomly varying block sizes.

Women in the antibiotic arm will get 3 tablets bioclavid (amoxicillin and Clavulanic acid) to take within the fist 24 hours of the delivery. The first tablet must be administrated within 6 hours of the delivery.

Group Type EXPERIMENTAL

Bioclavid (Amoxicillin and Clavulanic acid)

Intervention Type DRUG

We will evaluate how many women gets an infection and/or wound dehiscence after a second degree obstetric tear or episiotomy

Interventions

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Placebo

We will evaluate how many women gets an infection and/or wound dehiscence after a second degree obstetric tear or episiotomy

Intervention Type DRUG

Bioclavid (Amoxicillin and Clavulanic acid)

We will evaluate how many women gets an infection and/or wound dehiscence after a second degree obstetric tear or episiotomy

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Danish speaking women above 18 years
* Second degree perineal tear and/or episiotomy
* Suturing of obstetric tear at Herlev Hospital

Exclusion Criteria

* Allergies to the treatment.
* Women who end up with a cesarean-section, including those who have obstetric tears that require stitching or have had an episiotomy
* Women who receive antibiotics intra- or postpartum for other reasons.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Region Hovedstadens Apotek

OTHER_GOV

Sponsor Role collaborator

Hanna Jangö

OTHER

Sponsor Role lead

Responsible Party

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Hanna Jangö

Prinicipal investigator and sponsor

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Maternaty ward, Herlev Hospital

Herlev, , Denmark

Site Status

Countries

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Denmark

References

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Perslev K, Klarskov N, Bergholt T, Jango H. Risk of infection and wound dehiscence after use of prophylactic antibiotics in episiotomy or second degree tear (REPAIR study): single centre, double blind, placebo controlled randomised trial. BMJ. 2025 Oct 29;391:e084312. doi: 10.1136/bmj-2025-084312.

Reference Type DERIVED
PMID: 41161737 (View on PubMed)

Perslev K, Klarskov N, Bergholt T, Jango H. The REPAIR study: oral antibiotics to prevent infection and wound dehiscence after obstetric perineal tear-a double-blinded placebo controlled randomized trial. Trials. 2024 Mar 27;25(1):221. doi: 10.1186/s13063-024-08069-x.

Reference Type DERIVED
PMID: 38532503 (View on PubMed)

Other Identifiers

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2022-501930-49-00

Identifier Type: -

Identifier Source: org_study_id