As previously reported in the New England Journal of Medicine, Planned Parenthood Federation of America health centers changed their recommended regimen for medical abortions in the years 2006 and 2007, administering buccal rather than vaginal misoprostol and adding routine prophylactic antibiotics (doxycycline) in response to rare reports of serious infection after medical abortion. The effectiveness of this revised regimen in preventing C. sordellii infections and the safety of routine administration of antibiotics for this procedure remain unknown.
C. sordellii toxic shock syndrome may occur in reproductive-age women regardless of pregnancy status. Clinicians should be aware of common clinical features, including abdominal pain, hypotension, tachycardia, third-space fluid accumulations, hemoconcentration, and marked leukemoid response, typically without fever.
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