title: Treatment of Chlamydia trachomatis infections in pregnant women.
abstract: The intent of this article is to provide an overview of the epidemiology and pharmacotherapy, including cost analyses, of Chlamydia trachomatis infections in pregnant women. Chlamydia is a common sexually transmitted infection. For pregnant women, there are concerns both for the mother (post-partum endometritis, horizontal transmission) and the newborn (conjunctivitis, delayed pneumonia). Therapeutic options are restricted because of the fetus and include multi-day treatment with erythromycin, amoxicillin, clindamycin or single dose azithromycin. Clinical cure rates with these options are 86, 92, 93 and 95%, respectively. Pharmacoeconomic analyses have been conducted to determine if the initial increase in acquisition cost of azithromycin (approximately 3-fold higher than erythromycin or amoxicillin) is offset by improvement in compliance and drug efficacy. Clindamycin has received little attention because of its expense (4-fold more than azithromycin). Analyses have been retrospective. As models incorporate more complications of failure to cure, azithromycin increasingly becomes more cost effective and is our recommended treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Louisiana State University Medical Center, New Orleans 70112, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Miller
authors.forename: D H
authors.initials: DH
authors.lastname: Martin
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000191:economics / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D017963:Azithromycin / Q000191:economics / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000188:drug therapy*; D002692:Chlamydia trachomatis; D002981:Clindamycin / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D010406:Penicillins / Q000191:economics / Q000627:therapeutic use*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D002981:Clindamycin; D000658:Amoxicillin; D017963:Azithromycin