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Cathy K. Dratman, MD
Planned Parenthood of Southeastern Pennsylvania Philadelphia

JAMA. 1991;265(20):2671.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The study "Escherichia coli Bacteriuria and Contraceptive Method"¹ is potentially misleading. It must be noted that findings are of increased colonization only, not infection, correlated with barrier-spermicide use.

Is the documented vaginal flora alteration from the spermicide or from the latex of the condoms or diaphragm? Perhaps urinary tract colonization occurred from the increased lubrication of spermicides, creating easier access for bacteria to the urethra. We cannot tell, as there was no control group using a vaginal lubricant alone. What is the environment after intercourse without adjuvants of any kind? Perhaps the oral contraceptive group experienced a protective effect and the spermicide-barrier groups were actually closer to the noncontraceptive postcoital baseline. Also, the report did not include timing of postcoital washing. Women using barrier-spermicide methods are instructed not to wash for a number of hours after coitus; perhaps this delay in cleansing is the operant factor . . . [Full Text PDF of this Article]

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