Oral contraceptive failure rates and oral antibiotics.
*Antibiotics; *Case Control Studies; *Contraception Failure; *Contraceptives; *Drug Interactions; *Oral Contraceptives–side effects; *Pregnancy; *Research Report; Administration; Adolescent; Adult; Americas; Anti-Bacterial Agents/*administration & dosage/adverse effects; Combined; Contraception; Contraceptive Methods–side effects; Contraceptive Usage; Dermatology; Developed Countries; Drug Interactions; Drugs; Family Planning; Female; Humans; North America; Northern America; Oral; Research Methodology; Retrospective Studies; Studies; Treatment; United States
BACKGROUND: Despite anecdotal evidence of a possibility of decreased effectiveness of oral contraceptives (OCs) with some antibiotics, it is not known whether antibiotic use in dermatologic practices engenders any increased risk of accidental pregnancy. OBJECTIVE: Our purpose was to examine the effect of commonly prescribed oral antibiotics (tetracyclines, penicillins, cephalosporins) on the failure rate of OCs. METHODS: The records from three dermatology practices were reviewed, and 356 patients with a history of combined oral antibiotic/OC use were surveyed retrospectively. Of these patients, 263 also provided "control" data (during the times they used OCs alone). An additional 162 patients provided control data only. RESULTS: Five pregnancies occurred in 311 woman-years of combined antibiotic/OC exposure (1.6% per year failure rate) compared with 12 pregnancies in 1245 woman-years of exposure (0.96% per year) for the 425 control patients. This difference was not significant (p = 0.4), and the 95% confidence interval on the difference (-0.81, 2.1) ruled out a substantial difference (\textgreater 2.1% per year). There was also no significant difference between OC failure rates for the women who provided data under both conditions, nor between the two control groups. All our data groups had failure rates below the 3% or higher per year, which are typically found in the United States. CONCLUSION: The difference in failure rates of OCs when taken concurrently with antibiotics commonly used in dermatology versus OC use alone suggests that these antibiotics do not increase the risk of pregnancy. Physicians and patients need to recognize that the expected OC failure rate, regardless of antibiotic use, is at least 1% per year and it is not yet possible to predict in whom OCs may fail.
Helms S E; Bredle D L; Zajic J; Jarjoura D; Brodell R T; KrishnaRao I
Journal of the American Academy of Dermatology
1997
1997-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0190-9622(97)80322-2" target="_blank" rel="noreferrer noopener">10.1016/s0190-9622(97)80322-2</a>
Pregnant or recently pregnant opioid users: contraception decisions, perceptions and preferences.
Contraception; Opioid Drug Use; Pregnancy
Background: Multiple factors are linked to extremely high unintended pregnancy rates among women who use opioids, including various barriers to contraception adherence. These include patient level barriers such as lack of knowledge and education about highly effective contraception, and potential provider barriers. Using a mixed-methods framework to examine the contraception-related perceptions and preferences of opioid using women is a necessary next step to understanding this phenomenon. Methods: A mixed-method study was conducted which included both self-report questionnaires along with a semi-structured qualitative interview of opioid-using pregnant or recently pregnant women in two drug treatment facilities in Ohio. Results: Forty-two women completed the study. The majority of recent (75%) and total pregnancies were unintended. Male condoms were reported as the highest form of lifetime contraception used within the present sample (69%). Participants reported low lifetime use of long acting reversible contraception (LARC) (ranging from 5 to 12%). Participants preferred hormonal injections first (40%), followed by IUDs (17%). Reasons for preferences of injections and LARC were similar: not needing to remember, side effects, and long-term effectiveness. Conclusions: Most of the study population participants stated they would utilize contraception, particularly Tier 1 LARC methods, if freely available; however, high rates of unintended pregnancy were observed in this sample. This indicates the need for contraception education, and addressing the procedural, logistical and economic barriers that may be preventing the use of LARC among this population.
Fischbein Rebecca L; Lanese Bethany G; Falletta Lynn; Hamilton Kelsey; King Jennifer A; Kenne Deric R
Contraception and reproductive medicine
2018
2018
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s40834-018-0056-y" target="_blank" rel="noreferrer noopener">10.1186/s40834-018-0056-y</a>