Amoxicillin or erythromycin for the treatment of antenatal chlamydial infection: a meta-analysis.
OBJECTIVE
To compare the effectiveness of amoxicillin and erythromycin for the treatment of antenatal Chlamydia trachomatis infection by meta-analysis of available trials involving random assignment of subjects.


METHODS
A computer search of English-language abstracts using MEDLINE and the Cochrane Pregnancy and Childbirth Database (medical subject heading terms: pregnancy, chlamydia, erythromycin, amoxicillin, antenatal antibiotics) was supplemented with a review of the bibliographies of the relevant articles generated by the computer search.


METHODS
Five trials were identified, four of which met our inclusion criteria for the meta-analysis.


METHODS
Trials to be included in this meta-analysis underwent trial quality evaluation and data abstraction. An estimate of the relative risk (RR) was calculated for the dichotomous outcomes using a fixed-effects model. The pooled RR for the effectiveness of amoxicillin compared with erythromycin was 1.11 (95% confidence interval [CI] 1.05-1.18), and the pooled RR for gastrointestinal side effects of amoxicillin compared with erythromycin was 0.29 (95% CI 0.20-0.42). The pooled RR for gastrointestinal side effects that resulted in discontinuation of therapy of amoxicillin compared with erythromycin was 0.14 (95% CI 0.06-0.36).


CONCLUSIONS
The available data suggest that amoxicillin is more effective than erythromycin for the treatment of antenatal C trachomatis infection and has fewer gastrointestinal side effects, leading to better compliance.
Turrentine
M A
MA
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Houston Health Science Center, Houston, USA.
Newton
E R
ER
D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000188:drug therapy*; D002692:Chlamydia trachomatis; D002986:Clinical Trials as Topic; D004917:Erythromycin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D010406:Penicillins; D004917:Erythromycin; D000658:Amoxicillin