The Experts below are selected from a list of 222 Experts worldwide ranked by ideXlab platform
Elizabeth G. Raymond - One of the best experts on this subject based on the ideXlab platform.
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Spermicide used alone for contraception
Cochrane Database of Systematic Reviews, 2013Co-Authors: David A Grimes, K Nanda, Laureen M. Lopez, Elizabeth G. Raymond, Vera Halpern, Kenneth F. SchulzAbstract:BACKGROUND: Spermicides have been used as contraceptives for thousands of years. Despite this long use only recently have studies examined the comparative efficacy and acceptability of these vaginal medications. Spermicides contain an active ingredient (most commonly nonoxynol-9) and a formulation used to disperse the product such as foam or vaginal suppository. OBJECTIVES: This review examined all known randomized controlled trials of a Spermicide used alone for contraception. SEARCH METHODS: In August 2013 we searched the following computerized databases for randomized controlled trials of Spermicides for contraception: CENTRAL MEDLINE POPLINE LILACS EMBASE ClinicalTrials.gov and ICTRP. For the initial review we examined the reference lists of trials found as well as those of review articles and textbook chapters. SELECTION CRITERIA: We included any trial of a commercial product used alone for contraception. Each included trial must have provided sufficient information to determine pregnancy rates. DATA COLLECTION AND ANALYSIS: Two authors independently extracted information from the trials identified. We did not conduct a meta-analysis since most trials had large losses to follow up. We entered the data into tables and presented the results descriptively. MAIN RESULTS: We located reports from 14 trials for the initial review but have not identified any new trials since then. In the largest trial to date the gel (Advantage S) containing the lowest dose of nonoxynol-9 (52.5 mg) was significantly less effective in preventing pregnancy than were gels with higher doses of the same agent (100 mg and 150 mg). Probabilities of pregnancy by six months were 22% for the 52.5 mg gel 16% for the 100 mg dose and 14% for the 150 mg dose. In the same trial the three different vehicles with 100 mg of nonoxynol-9 had similar efficacy. Interpretation of these figures is limited since 39% of participants discontinued the method or were lost from the trial. Few important differences in efficacy emerged in other trials. AUTHORS CONCLUSIONS: The probability of pregnancy varied widely in reported trials. A gel containing nonoxynol-9 52.5 mg was inferior to two other products tested in the largest trial. Aside from this finding personal characteristics and behavior of users may be more important than characteristics of the Spermicide products in determining the probability of pregnancy. Gel was liked more than the film or vaginal suppository in the largest trial. Spermicide trials have the dual challenges of difficult recruitment and high discontinuation rates; the latter threatens trial validity.
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The Cochrane Library - Spermicide used alone for contraception
The Cochrane database of systematic reviews, 2013Co-Authors: David A Grimes, K Nanda, Laureen M. Lopez, Elizabeth G. Raymond, Vera Halpern, Kenneth F. SchulzAbstract:BACKGROUND: Spermicides have been used as contraceptives for thousands of years. Despite this long use only recently have studies examined the comparative efficacy and acceptability of these vaginal medications. Spermicides contain an active ingredient (most commonly nonoxynol-9) and a formulation used to disperse the product such as foam or vaginal suppository. OBJECTIVES: This review examined all known randomized controlled trials of a Spermicide used alone for contraception. SEARCH METHODS: In August 2013 we searched the following computerized databases for randomized controlled trials of Spermicides for contraception: CENTRAL MEDLINE POPLINE LILACS EMBASE ClinicalTrials.gov and ICTRP. For the initial review we examined the reference lists of trials found as well as those of review articles and textbook chapters. SELECTION CRITERIA: We included any trial of a commercial product used alone for contraception. Each included trial must have provided sufficient information to determine pregnancy rates. DATA COLLECTION AND ANALYSIS: Two authors independently extracted information from the trials identified. We did not conduct a meta-analysis since most trials had large losses to follow up. We entered the data into tables and presented the results descriptively. MAIN RESULTS: We located reports from 14 trials for the initial review but have not identified any new trials since then. In the largest trial to date the gel (Advantage S) containing the lowest dose of nonoxynol-9 (52.5 mg) was significantly less effective in preventing pregnancy than were gels with higher doses of the same agent (100 mg and 150 mg). Probabilities of pregnancy by six months were 22% for the 52.5 mg gel 16% for the 100 mg dose and 14% for the 150 mg dose. In the same trial the three different vehicles with 100 mg of nonoxynol-9 had similar efficacy. Interpretation of these figures is limited since 39% of participants discontinued the method or were lost from the trial. Few important differences in efficacy emerged in other trials. AUTHORS CONCLUSIONS: The probability of pregnancy varied widely in reported trials. A gel containing nonoxynol-9 52.5 mg was inferior to two other products tested in the largest trial. Aside from this finding personal characteristics and behavior of users may be more important than characteristics of the Spermicide products in determining the probability of pregnancy. Gel was liked more than the film or vaginal suppository in the largest trial. Spermicide trials have the dual challenges of difficult recruitment and high discontinuation rates; the latter threatens trial validity.
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Spermicide used alone for contraception.
The Cochrane database of systematic reviews, 2013Co-Authors: David A Grimes, K Nanda, Laureen M. Lopez, Elizabeth G. Raymond, Vera Halpern, Kenneth F. SchulzAbstract:Spermicides have been used as contraceptives for thousands of years. Despite this long use, only recently have studies examined the comparative efficacy and acceptability of these vaginal medications. Spermicides contain an active ingredient (most commonly nonoxynol-9) and a formulation used to disperse the product, such as foam or vaginal suppository. This review examined all known randomized controlled trials of a Spermicide used alone for contraception. In August 2013, we searched the following computerized databases for randomized controlled trials of Spermicides for contraception: CENTRAL, MEDLINE, POPLINE, LILACS, EMBASE, ClinicalTrials.gov, and ICTRP. For the initial review, we examined the reference lists of trials found as well as those of review articles and textbook chapters. We included any trial of a commercial product used alone for contraception. Each included trial must have provided sufficient information to determine pregnancy rates. Two authors independently extracted information from the trials identified. We did not conduct a meta-analysis, since most trials had large losses to follow up. We entered the data into tables and presented the results descriptively. We located reports from 14 trials for the initial review, but have not identified any new trials since then. In the largest trial to date, the gel (Advantage S) containing the lowest dose of nonoxynol-9 (52.5 mg) was significantly less effective in preventing pregnancy than were gels with higher doses of the same agent (100 mg and 150 mg). Probabilities of pregnancy by six months were 22% for the 52.5 mg gel, 16% for the 100 mg dose, and 14% for the 150 mg dose. In the same trial, the three different vehicles with 100 mg of nonoxynol-9 had similar efficacy. Interpretation of these figures is limited, since 39% of participants discontinued the method or were lost from the trial. Few important differences in efficacy emerged in other trials. The probability of pregnancy varied widely in reported trials. A gel containing nonoxynol-9 52.5 mg was inferior to two other products tested in the largest trial. Aside from this finding, personal characteristics and behavior of users may be more important than characteristics of the Spermicide products in determining the probability of pregnancy. Gel was liked more than the film or vaginal suppository in the largest trial. Spermicide trials have the dual challenges of difficult recruitment and high discontinuation rates; the latter threatens trial validity.
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Cervicovaginal colposcopic lesions associated with 5 nonoxynol-9 vaginal Spermicide formulations.
American journal of obstetrics and gynecology, 2008Co-Authors: Bryna Harwood, David F Archer, Elizabeth G. Raymond, Leslie A Meyn, Susan A Ballagh, Mitchell D. CreininAbstract:This study was undertaken to compare the colposcopic appearance of the cervicovaginal epithelium with Spermicide use vs condom use in a low-risk population. This was an ancillary study of a trial comparing the efficacy of 5 nonoxynol-9 Spermicides. A cohort of women who used condoms without Spermicide served as a control group. Colposcopic examinations were performed during product use to identify genital lesions. One hundred fifty-one participants had 1 or more follow-up examinations. At baseline, study groups differed only by the prevalence of baseline lesions. New lesions were identified at 49% of follow-up visits. Controlling for the presence of a baseline lesion, compared with condom use none of the Spermicides were associated with an increase in new lesions (overall odds ratio, 0.8; 95% CI, 0.4-1.6; P = .5); and lesions characterized by epithelial disruption were less frequent with Spermicide use (overall odds ratio, 0.3; 95% CI, 0.1-0.6; P < .001). In a low-risk population, women who used nonoxynol-9 Spermicides were less likely to have lesions with epithelial disruption, and equally likely to have any new lesion compared with condom use.
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Cervicovaginal colposcopic lesions associated with 5 nonoxynol-9 vaginal Spermicide formulations.
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Bryna Harwood, David F Archer, Elizabeth G. Raymond, Leslie A Meyn, Susan A Ballagh, Mitchell D. CreininAbstract:Objective This study was undertaken to compare the colposcopic appearance of the cervicovaginal epithelium with Spermicide use vs condom use in a low-risk population. Study Design This was an ancillary study of a trial comparing the efficacy of 5 nonoxynol-9 Spermicides. A cohort of women who used condoms without Spermicide served as a control group. Colposcopic examinations were performed during product use to identify genital lesions. Results One hundred fifty-one participants had 1 or more follow-up examinations. At baseline, study groups differed only by the prevalence of baseline lesions. New lesions were identified at 49% of follow-up visits. Controlling for the presence of a baseline lesion, compared with condom use none of the Spermicides were associated with an increase in new lesions (overall odds ratio, 0.8; 95% CI, 0.4-1.6; P = .5); and lesions characterized by epithelial disruption were less frequent with Spermicide use (overall odds ratio, 0.3; 95% CI, 0.1-0.6; P Conclusion In a low-risk population, women who used nonoxynol-9 Spermicides were less likely to have lesions with epithelial disruption, and equally likely to have any new lesion compared with condom use.
Delia Scholes - One of the best experts on this subject based on the ideXlab platform.
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use of Spermicide coated condoms and other risk factors for urinary tract infection caused by staphylococcus saprophyticus
The Journal of Urology, 1998Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia ScholesAbstract:tients. Exposure to Spermicide-coated condoms during the previous month was associated with a higher risk of UTI (odds ratio [OR], 3.8; 95% confidence interval,1.410.3). The OR for exposure during the previous year ranged from 2.2 (95% confidence interval, 1.0-4.8) for less than once weekly to 6.05 (95% confidence interval, 2.2-16.6) for more than twice weekly. In multivariate analyses, younger age (OR, 0.97 per year), intercourse frequency (OR, 1.2 per weekly episode), prior UTI (OR, 3.3), and frequency of exposure to Spermicide-coated condoms (OR, 8.4 for more than once weekly and 10.9 for more than twice weekly) were independent predictors of UTI. Among women exposed to Spermicide-coated condoms, 74% of UTIs caused by S saprophyticus were attributable to this exposure. Conclusions: Spermicide-coated condoms were associated with an increased risk of UTI caused by S saprophyticus. Because sexual activity and Spermicide exposure are important risk factors for UTI caused by both S saprophyticus and E coli, it is likely that they share a similar pathogenesis. Arch Intern Med. 1998;158:281-287
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use of Spermicide coated condoms and other risk factors for urinary tract infection caused by staphylococcus saprophyticus
JAMA Internal Medicine, 1998Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia ScholesAbstract:Background Staphylococcus saprophyticus is the second most common cause of urinary tract infection (UTI) in young women. Relatively little is known about risk factors for this infection including exposure to vaginal Spermicides, which increases the risk of UTI caused by Escherichia coli . Patients and Methods We conducted a case-control study in a large health maintenance organization. Case patients were sexually active young women with acute UTIs caused by S saprophyticus identified from computerized laboratory files during 1990 to 1993. Population-based control patients were randomly selected from the organization's enrollment files. Exposures such as sexual activity and contraceptive practice were determined by interview. Results Of 1299 eligible women, 66% (96 case patients and 629 control patients) were interviewed. Case patients were more often unmarried and were more sexually active. Ninety-nine percent of case patients and 57% of control patients reported previous UTIs. Exposure to any type of condom during the previous year was reported by 53% of case patients and 31% of control patients. Exposure to Spermicide-coated condoms during the previous month was associated with a higher risk of UTI (odds ratio [OR], 3.8; 95% confidence interval,1.4-10.3). The OR for exposure during the previous year ranged from 2.2 (95% confidence interval, 1.0-4.8) for less than once weekly to 6.05 (95% confidence interval, 2.2-16.6) for more than twice weekly. In multivariate analyses, younger age (OR, 0.97 per year), intercourse frequency (OR, 1.2 per weekly episode), prior UTI (OR, 3.3), and frequency of exposure to Spermicide-coated condoms (OR, 8.4 for more than once weekly and 10.9 for more than twice weekly) were independent predictors of UTI. Among women exposed to Spermicide-coated condoms, 74% of UTIs caused by S saprophyticus were attributable to this exposure. Conclusions Spermicide-coated condoms were associated with an increased risk of UTI caused by S saprophyticus . Because sexual activity and Spermicide exposure are important risk factors for UTI caused by both S saprophyticus and E coli , it is likely that they share a similar pathogenesis.
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association between use of Spermicide coated condoms and escherichia coli urinary tract infection in young women
American Journal of Epidemiology, 1996Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia Scholes, Jane Grafton, Marcia Hunt, Andy StergachisAbstract:Diaphragm/Spermicide use increases the risk of urinary tract infection (UTI). To determine whether Spermicide-coated condoms are also associated with an increased risk of UTI, the authors conducted a case-control study at a large health maintenance organization in Seattle, Washington. Cases were sexually active young women with acute UTI caused by Escherichia coli, identified from computerized laboratory files during 1990-1993. Age-matched controls were randomly selected from the enrollment files of the plan. Of 1,904 eligible women, 604 cases and 629 controls (65%) were interviewed. During the previous year, 40% of the cases and 31% of the controls had been exposed to any type of condom. The unadjusted odds ratio for UTI increased with frequency of condom exposure from 0.91 (95% confidence interval (CI) 0.65-1.28) for weekly or less during the previous month to 2.11 (95% CI 1.37-3.26) for more than once weekly. Exposure to Spermicide-coated condoms conferred a higher risk of UTI, with odds ratios ranging from 1.09 (95% CI 0.58-2.05) for use weekly or less to 3.05 (95% CI 1.47-6.35) for use more than once weekly. In multivariate analyses, intercourse frequency (odds ratio (OR) = 1.14 per weekly episode), history of UTI (OR = 2.64), and frequency of Spermicide-coated condom exposure (OR = 3.34 for more than once weekly and 5.65 for use more than twice weekly) were independent predictors of UTI. Spermicide-coated condoms were responsible for 42% of the UTIs among women who were exposed to these products.
Stephan D Fihn - One of the best experts on this subject based on the ideXlab platform.
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use of Spermicide coated condoms and other risk factors for urinary tract infection caused by staphylococcus saprophyticus
The Journal of Urology, 1998Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia ScholesAbstract:tients. Exposure to Spermicide-coated condoms during the previous month was associated with a higher risk of UTI (odds ratio [OR], 3.8; 95% confidence interval,1.410.3). The OR for exposure during the previous year ranged from 2.2 (95% confidence interval, 1.0-4.8) for less than once weekly to 6.05 (95% confidence interval, 2.2-16.6) for more than twice weekly. In multivariate analyses, younger age (OR, 0.97 per year), intercourse frequency (OR, 1.2 per weekly episode), prior UTI (OR, 3.3), and frequency of exposure to Spermicide-coated condoms (OR, 8.4 for more than once weekly and 10.9 for more than twice weekly) were independent predictors of UTI. Among women exposed to Spermicide-coated condoms, 74% of UTIs caused by S saprophyticus were attributable to this exposure. Conclusions: Spermicide-coated condoms were associated with an increased risk of UTI caused by S saprophyticus. Because sexual activity and Spermicide exposure are important risk factors for UTI caused by both S saprophyticus and E coli, it is likely that they share a similar pathogenesis. Arch Intern Med. 1998;158:281-287
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use of Spermicide coated condoms and other risk factors for urinary tract infection caused by staphylococcus saprophyticus
JAMA Internal Medicine, 1998Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia ScholesAbstract:Background Staphylococcus saprophyticus is the second most common cause of urinary tract infection (UTI) in young women. Relatively little is known about risk factors for this infection including exposure to vaginal Spermicides, which increases the risk of UTI caused by Escherichia coli . Patients and Methods We conducted a case-control study in a large health maintenance organization. Case patients were sexually active young women with acute UTIs caused by S saprophyticus identified from computerized laboratory files during 1990 to 1993. Population-based control patients were randomly selected from the organization's enrollment files. Exposures such as sexual activity and contraceptive practice were determined by interview. Results Of 1299 eligible women, 66% (96 case patients and 629 control patients) were interviewed. Case patients were more often unmarried and were more sexually active. Ninety-nine percent of case patients and 57% of control patients reported previous UTIs. Exposure to any type of condom during the previous year was reported by 53% of case patients and 31% of control patients. Exposure to Spermicide-coated condoms during the previous month was associated with a higher risk of UTI (odds ratio [OR], 3.8; 95% confidence interval,1.4-10.3). The OR for exposure during the previous year ranged from 2.2 (95% confidence interval, 1.0-4.8) for less than once weekly to 6.05 (95% confidence interval, 2.2-16.6) for more than twice weekly. In multivariate analyses, younger age (OR, 0.97 per year), intercourse frequency (OR, 1.2 per weekly episode), prior UTI (OR, 3.3), and frequency of exposure to Spermicide-coated condoms (OR, 8.4 for more than once weekly and 10.9 for more than twice weekly) were independent predictors of UTI. Among women exposed to Spermicide-coated condoms, 74% of UTIs caused by S saprophyticus were attributable to this exposure. Conclusions Spermicide-coated condoms were associated with an increased risk of UTI caused by S saprophyticus . Because sexual activity and Spermicide exposure are important risk factors for UTI caused by both S saprophyticus and E coli , it is likely that they share a similar pathogenesis.
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association between use of Spermicide coated condoms and escherichia coli urinary tract infection in young women
American Journal of Epidemiology, 1996Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia Scholes, Jane Grafton, Marcia Hunt, Andy StergachisAbstract:Diaphragm/Spermicide use increases the risk of urinary tract infection (UTI). To determine whether Spermicide-coated condoms are also associated with an increased risk of UTI, the authors conducted a case-control study at a large health maintenance organization in Seattle, Washington. Cases were sexually active young women with acute UTI caused by Escherichia coli, identified from computerized laboratory files during 1990-1993. Age-matched controls were randomly selected from the enrollment files of the plan. Of 1,904 eligible women, 604 cases and 629 controls (65%) were interviewed. During the previous year, 40% of the cases and 31% of the controls had been exposed to any type of condom. The unadjusted odds ratio for UTI increased with frequency of condom exposure from 0.91 (95% confidence interval (CI) 0.65-1.28) for weekly or less during the previous month to 2.11 (95% CI 1.37-3.26) for more than once weekly. Exposure to Spermicide-coated condoms conferred a higher risk of UTI, with odds ratios ranging from 1.09 (95% CI 0.58-2.05) for use weekly or less to 3.05 (95% CI 1.47-6.35) for use more than once weekly. In multivariate analyses, intercourse frequency (odds ratio (OR) = 1.14 per weekly episode), history of UTI (OR = 2.64), and frequency of Spermicide-coated condom exposure (OR = 3.34 for more than once weekly and 5.65 for use more than twice weekly) were independent predictors of UTI. Spermicide-coated condoms were responsible for 42% of the UTIs among women who were exposed to these products.
David F Archer - One of the best experts on this subject based on the ideXlab platform.
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Cervicovaginal colposcopic lesions associated with 5 nonoxynol-9 vaginal Spermicide formulations.
American journal of obstetrics and gynecology, 2008Co-Authors: Bryna Harwood, David F Archer, Elizabeth G. Raymond, Leslie A Meyn, Susan A Ballagh, Mitchell D. CreininAbstract:This study was undertaken to compare the colposcopic appearance of the cervicovaginal epithelium with Spermicide use vs condom use in a low-risk population. This was an ancillary study of a trial comparing the efficacy of 5 nonoxynol-9 Spermicides. A cohort of women who used condoms without Spermicide served as a control group. Colposcopic examinations were performed during product use to identify genital lesions. One hundred fifty-one participants had 1 or more follow-up examinations. At baseline, study groups differed only by the prevalence of baseline lesions. New lesions were identified at 49% of follow-up visits. Controlling for the presence of a baseline lesion, compared with condom use none of the Spermicides were associated with an increase in new lesions (overall odds ratio, 0.8; 95% CI, 0.4-1.6; P = .5); and lesions characterized by epithelial disruption were less frequent with Spermicide use (overall odds ratio, 0.3; 95% CI, 0.1-0.6; P < .001). In a low-risk population, women who used nonoxynol-9 Spermicides were less likely to have lesions with epithelial disruption, and equally likely to have any new lesion compared with condom use.
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Cervicovaginal colposcopic lesions associated with 5 nonoxynol-9 vaginal Spermicide formulations.
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Bryna Harwood, David F Archer, Elizabeth G. Raymond, Leslie A Meyn, Susan A Ballagh, Mitchell D. CreininAbstract:Objective This study was undertaken to compare the colposcopic appearance of the cervicovaginal epithelium with Spermicide use vs condom use in a low-risk population. Study Design This was an ancillary study of a trial comparing the efficacy of 5 nonoxynol-9 Spermicides. A cohort of women who used condoms without Spermicide served as a control group. Colposcopic examinations were performed during product use to identify genital lesions. Results One hundred fifty-one participants had 1 or more follow-up examinations. At baseline, study groups differed only by the prevalence of baseline lesions. New lesions were identified at 49% of follow-up visits. Controlling for the presence of a baseline lesion, compared with condom use none of the Spermicides were associated with an increase in new lesions (overall odds ratio, 0.8; 95% CI, 0.4-1.6; P = .5); and lesions characterized by epithelial disruption were less frequent with Spermicide use (overall odds ratio, 0.3; 95% CI, 0.1-0.6; P Conclusion In a low-risk population, women who used nonoxynol-9 Spermicides were less likely to have lesions with epithelial disruption, and equally likely to have any new lesion compared with condom use.
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A phase I study of Femcap used with and without Spermicide. Postcoital testing.
Contraception, 1997Co-Authors: Christine K Mauck, Jay M. Baker, Susan P. Barr, Wendy Johanson, David F ArcherAbstract:Abstract The objectives of the study were to assess the ability of the Femcap ® , a new vaginal contraceptive device made of silicone and designed to fit snugly around the cervix to prevent the penetration of sperm into midcycle cervical mucus when used with and without Spermicide; and to compare it with the standard contraceptive diaphragm used with Spermicide. Eight women underwent two baseline cycles of postcoital testing in which no device was used, followed by three test cycles in which Femcan with Spermicide, Femcap with nonspermicidal lubricant (KY ® gel) or the Ortho All-Flex ® diaphragm with Spermicide was used. The sequence of testing cycles was randomized. In each cycle, condoms were used prior to midcycle, then a midcycle cervical mucus specimen was examined to ensure midcycle characteristics and the absence of sperm. Each woman then had intercourse using either no device (baseline cycles) or the prescribed device (test cycles) and returned 2–3 h afterwards. Cervical mucus was again assessed for adequacy and the presence of spermatozoa. The average number of progressively motile sperm seen per high power field was as follows: first baseline cycle, 18.0; second baseline cycle, 17.8; test cycle with Femcap used with nonspermicidal lubricant, 0.1; test cycle with Femcap used with Spermicide, 0.2; and test cycle with the diaphragm used with Spermicide, 0.0. There was no significant difference between baseline cycles or among test cycles in the average number of progressively motile sperm seen (p > 0.05). the average number of progressively motile sperm seen in each test cycle did, however, differ significantly from the average number seen in either baseline cycle (p Femcap, used with either a spermicidal lubricant or a nonspermicidal lubricant, appears to be comparable with the diaphragm used with Spermicide in preventing sperm from entering midcycle cervical mucus.
Chi Ling Chen - One of the best experts on this subject based on the ideXlab platform.
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use of Spermicide coated condoms and other risk factors for urinary tract infection caused by staphylococcus saprophyticus
The Journal of Urology, 1998Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia ScholesAbstract:tients. Exposure to Spermicide-coated condoms during the previous month was associated with a higher risk of UTI (odds ratio [OR], 3.8; 95% confidence interval,1.410.3). The OR for exposure during the previous year ranged from 2.2 (95% confidence interval, 1.0-4.8) for less than once weekly to 6.05 (95% confidence interval, 2.2-16.6) for more than twice weekly. In multivariate analyses, younger age (OR, 0.97 per year), intercourse frequency (OR, 1.2 per weekly episode), prior UTI (OR, 3.3), and frequency of exposure to Spermicide-coated condoms (OR, 8.4 for more than once weekly and 10.9 for more than twice weekly) were independent predictors of UTI. Among women exposed to Spermicide-coated condoms, 74% of UTIs caused by S saprophyticus were attributable to this exposure. Conclusions: Spermicide-coated condoms were associated with an increased risk of UTI caused by S saprophyticus. Because sexual activity and Spermicide exposure are important risk factors for UTI caused by both S saprophyticus and E coli, it is likely that they share a similar pathogenesis. Arch Intern Med. 1998;158:281-287
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use of Spermicide coated condoms and other risk factors for urinary tract infection caused by staphylococcus saprophyticus
JAMA Internal Medicine, 1998Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia ScholesAbstract:Background Staphylococcus saprophyticus is the second most common cause of urinary tract infection (UTI) in young women. Relatively little is known about risk factors for this infection including exposure to vaginal Spermicides, which increases the risk of UTI caused by Escherichia coli . Patients and Methods We conducted a case-control study in a large health maintenance organization. Case patients were sexually active young women with acute UTIs caused by S saprophyticus identified from computerized laboratory files during 1990 to 1993. Population-based control patients were randomly selected from the organization's enrollment files. Exposures such as sexual activity and contraceptive practice were determined by interview. Results Of 1299 eligible women, 66% (96 case patients and 629 control patients) were interviewed. Case patients were more often unmarried and were more sexually active. Ninety-nine percent of case patients and 57% of control patients reported previous UTIs. Exposure to any type of condom during the previous year was reported by 53% of case patients and 31% of control patients. Exposure to Spermicide-coated condoms during the previous month was associated with a higher risk of UTI (odds ratio [OR], 3.8; 95% confidence interval,1.4-10.3). The OR for exposure during the previous year ranged from 2.2 (95% confidence interval, 1.0-4.8) for less than once weekly to 6.05 (95% confidence interval, 2.2-16.6) for more than twice weekly. In multivariate analyses, younger age (OR, 0.97 per year), intercourse frequency (OR, 1.2 per weekly episode), prior UTI (OR, 3.3), and frequency of exposure to Spermicide-coated condoms (OR, 8.4 for more than once weekly and 10.9 for more than twice weekly) were independent predictors of UTI. Among women exposed to Spermicide-coated condoms, 74% of UTIs caused by S saprophyticus were attributable to this exposure. Conclusions Spermicide-coated condoms were associated with an increased risk of UTI caused by S saprophyticus . Because sexual activity and Spermicide exposure are important risk factors for UTI caused by both S saprophyticus and E coli , it is likely that they share a similar pathogenesis.
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association between use of Spermicide coated condoms and escherichia coli urinary tract infection in young women
American Journal of Epidemiology, 1996Co-Authors: Stephan D Fihn, Edward J Boyko, Chi Ling Chen, Esther H Normand, Patricia Yarbro, Delia Scholes, Jane Grafton, Marcia Hunt, Andy StergachisAbstract:Diaphragm/Spermicide use increases the risk of urinary tract infection (UTI). To determine whether Spermicide-coated condoms are also associated with an increased risk of UTI, the authors conducted a case-control study at a large health maintenance organization in Seattle, Washington. Cases were sexually active young women with acute UTI caused by Escherichia coli, identified from computerized laboratory files during 1990-1993. Age-matched controls were randomly selected from the enrollment files of the plan. Of 1,904 eligible women, 604 cases and 629 controls (65%) were interviewed. During the previous year, 40% of the cases and 31% of the controls had been exposed to any type of condom. The unadjusted odds ratio for UTI increased with frequency of condom exposure from 0.91 (95% confidence interval (CI) 0.65-1.28) for weekly or less during the previous month to 2.11 (95% CI 1.37-3.26) for more than once weekly. Exposure to Spermicide-coated condoms conferred a higher risk of UTI, with odds ratios ranging from 1.09 (95% CI 0.58-2.05) for use weekly or less to 3.05 (95% CI 1.47-6.35) for use more than once weekly. In multivariate analyses, intercourse frequency (odds ratio (OR) = 1.14 per weekly episode), history of UTI (OR = 2.64), and frequency of Spermicide-coated condom exposure (OR = 3.34 for more than once weekly and 5.65 for use more than twice weekly) were independent predictors of UTI. Spermicide-coated condoms were responsible for 42% of the UTIs among women who were exposed to these products.