Several interesting issues have been raised by Dr Duguid and colleagues. They have not only confirmed our observations on the value of cervicovaginal smears in Actinomyces diagnosis, but have achieved unique success with cultures of these anaerobic organisms.In our experience with more than 100,000 cervicovaginal smears and detection of nearly a thousand cases of Actinomyces infection, organisms have not always been easy to recognize. Cervical material from 197 plastic-IUD users and 209 copper-IUD users should be stained with specific antisera to establish definitive diagnosis before ascribing any protective effect of copper IUD. Although need exists for better studies, no such difference in the prevalence of Actinomyces among copper-IUD users'has been observed by us and other workers in the United States.1 Dr Duguid and co-workers have correctly pointed out that the apparent protective effect of the copper IUD is probably due to its frequent replacement.For women
Gupta PK, Woodruff DJ. Actinomyces and Intrauterine Devices-Reply. JAMA. 1982;248(13):1579–1580. doi:10.1001/jama.1982.03330130027015
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