Interventions for treating genital chlamydia trachomatis infection in pregnancy.
BACKGROUND
Chlamydia trachomatis is a sexually transmitted infection. Mother-to-child transmission can occur at the time of birth and may result in ophthalmia neonatorum or pneumonitis in the newborn.


OBJECTIVE
The objective of this review was to assess the effects of antibiotics in the treatment of genital infection with Chlamydia trachomatis during pregnancy with respect to neonatal and maternal morbidity.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register (Cochrane Library issue 1, 1999).


METHODS
Randomised trials of any antibiotic regimen compared with placebo or no treatment or alternative antibiotic regimens in pregnant women with genital Chlamydia trachomatis infection.


METHODS
Trial quality assessments and data extraction were done independently by two reviewers. Study authors were contacted for additional information.


RESULTS
Eleven trials were included. Trial quality was generally good. Amoxycillin appeared to be as effective as erythromycin in achieving microbiological cure (odds ratio 0.54, 95% confidence interval 0.28 to 1.02). Amoxycillin was better tolerated than erythromycin (odds ratio 0.16, 95% confidence interval 0.09 to 0.30). Clindamycin and azithromycin also appear to be effective, although the numbers of women included in trials are small.


CONCLUSIONS
Amoxycillin appears to be an acceptable alternative therapy for the treatment of genital chlamydial infections in pregnancy when compared with erythromycin. Clindamycin and azithromycin may be considered if erythromycin and amoxycillin are contra-indicated or not tolerated.
Brocklehurst
P
P
National Perinatal Epidemiology Unit, Institute of Health Sciences, Old Road, Headington, Oxford, UK, OX3 7LF. peter.brocklehurst@perinat.ox.ac.uk
Rooney
G
G
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000188:drug therapy* / Q000635:transmission*; D002692:Chlamydia trachomatis; D005260:Female; D005831:Genital Diseases, Female / Q000188:drug therapy*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*
D000900:Anti-Bacterial Agents