Azithromycin and erythromycin in the treatment of cervical chlamydial infection during pregnancy.
OBJECTIVE
To compare azithromycin and erythromycin in regard to side effects, intolerance, and cure rate in a pregnant population with chlamydial cervicitis.


METHODS
Thirty women were randomized to receive either erythromycin, 500 mg orally four times a day for 7 days, or azithromycin, 1 g orally as one dose. All subjects completed questionnaires identifying the incidence of nausea, vomiting, diarrhea, abdominal pain, and anorexia. Post-treatment cultures were taken from all subjects.


RESULTS
All subjects receiving erythromycin reported two or more gastrointestinal side effects, versus none in the azithromycin group (P < .001). Five of 15 subjects in the erythromycin treatment arm were intolerant to the 500-mg dose given four times a day, compared to none in the azithromycin group (P < .025), so the dosage was lowered to 250 mg four times a day to complete the course. Repeat cervical testing demonstrated similar cure rates for both medications: 100 and 93% (14 of 15) for azithromycin and erythromycin, respectively.


CONCLUSIONS
These data suggest that azithromycin is a valid treatment option in pregnant patients who cannot tolerate erythromycin because of side effects.
Bush
M R
MR
Department of Obstetrics and Gynecology, William Beaumont Army Medical Center, El Paso, Texas.
Rosa
C
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D000284:Administration, Oral; D017963:Azithromycin / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000188:drug therapy* / Q000382:microbiology; D004917:Erythromycin / Q000627:therapeutic use*; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000382:microbiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016312:Treatment Refusal; D002577:Uterine Cervical Diseases / Q000188:drug therapy* / Q000382:microbiology
D004917:Erythromycin; D017963:Azithromycin