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: ObjectiveTo assess the ability of clindamycin vaginal cream to reduce the incidence of preterm birth in women with abnormal genital tract flora in the second trimester of pregnancy.: MethodsThis was a randomized, double-blind, placebo-controlled, tricenter study. A total of 409 women with abnormal genital tract flora on Gram stain of vaginal secretions at 13–20 weeks’ gestation were randomized to receive a 3-day course of clindamycin vaginal cream or placebo. Those women who still had abnormal vaginal flora 3 weeks later received a 7-day course of the original study drug (ie, either clindamycin vaginal cream or placebo as per original randomization). The primary outcome measure was the incidence of preterm birth.: ResultsThere was a statistically significant reduction in the incidence of preterm birth in the clindamycin vaginal cream group (4%) compared with placebo (10%) (P < .03). Significantly more babies born preterm (63%) required admission to the neonatal intensive care unit compared with term infants (4%) (P < .001).: ConclusionA 2% clindamycin vaginal cream, when compared with placebo administered to women with abnormal genital tract flora before 20 weeks’ gestation, can reduce the incidence of preterm birth by 60% and hence the need for neonatal intensive care. [Copyright &y& Elsevier]

A letter to the editor is presented in response to the article on oxytocin antagonist inhibiting preterm labor.