A two-week course of broad-spectrum oral antibiotic therapy helps resolve chronic endometritis (CE) in about 90 percent of cases, although it is unclear whether this beneficial effect translates to improved pregnancy outcomes, according to a study.
A total of 132 women with CE, confirmed using immunohistochemical study with CD138 epitope, were randomized to receive oral levofloxacin 500 mg plus tinidazole 1,000 mg daily for 14 days or to no treatment.
All women underwent a repeated endometrial biopsy 4 to 8 weeks after the initial biopsy to determine whether CE was still present. Treatment efficacy was assessed based on the rate of negative test results for CE (from positive to negative).
The rate of negative test results was significantly higher in the treatment group after one course of antibiotic treatment than in the control group (89.3 percent vs 12.7 percent).
Among women who attempted pregnancy, there was no significant differences observed between the treatment and control groups in ongoing pregnancy rates (43.2 percent vs 25.7 percent) and miscarriage rates (5.4 percent vs 14.3 percent).
The same was true among all the women randomized, with pregnancy rates being 27 percent versus 16.4 percent and miscarriage rates being 3.4 percent versus 9.1 percent, respectively.