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October 1, 1982

Actinomyces and Intrauterine Devices

Author Affiliations

University of Dundee Dundee, Scotland

JAMA. 1982;248(13):1579. doi:10.1001/jama.1982.03330130027014

To the Editor.—  It was with interest that we read the recent editorial on Actinomyces in vaginal smears (1982; 247:1175), suggesting that women who had Actinomyces-positive smears should use a contraceptive method other than the intrauterine device (IUD). This report was publicized in the British lay press.We have examined cervical material from 197 plastic-device users and 209 copper-device users, and have found1,2 a significant difference in the prevalence of actinomycete infestation between the two groups (42% and 2%, respectively). In every case, the type of device and duration of use were noted, the comparison being almost exclusively between Saf-T-Coil and Gravigard.In the first retrospective study, actinomycetes were identified by morphological characteristics in direct cervical smears. In the second prospective study, they were identified on culture supported by specific immunofluorescence, positive results being obtained in 37 of 75 IUD users tested. Using our previously reported culture technique