title: On the pathway to better birth outcomes? A systematic review of azithromycin and curable sexually transmitted infections.
abstract: The WHO recommends the administration of sulfadoxine-pyrimethamine (SP) to all pregnant women living in areas of moderate (stable) to high malaria transmission during scheduled antenatal visits, beginning in the second trimester and continuing to delivery. Malaria parasites have lost sensitivity to SP in many endemic areas, prompting the investigation of alternatives that include azithromycin-based combination (ABC) therapies. Use of ABC therapies may also confer protection against curable sexually transmitted infections and reproductive tract infections (STIs/RTIs). The magnitude of protection at the population level would depend on the efficacy of the azithromycin-based regimen used and the underlying prevalence of curable STIs/RTIs among pregnant women who receive preventive treatment. This systematic review summarizes the efficacy data of azithromycin against curable STIs/RTIs.
authors.affiliation: London School of Hygiene and Tropical Medicine Keppel Street, London, WC1E 7HT, UK.
authors.forename: R Matthew
authors.initials: RM
authors.lastname: Chico
authors.forename: Berkin B
authors.initials: BB
authors.lastname: Hack
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Newport
authors.forename: Enesia
authors.initials: E
authors.lastname: Ngulube
authors.forename: Daniel
authors.initials: D
authors.lastname: Chandramohan
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011739:Pyrimethamine / Q000627:therapeutic use; D060737:Reproductive Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D012749:Sexually Transmitted Diseases / Q000188:drug therapy* / Q000382:microbiology; D013413:Sulfadoxine / Q000627:therapeutic use; D016896:Treatment Outcome; D016585:Vaginosis, Bacterial / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D017963:Azithromycin; D013413:Sulfadoxine; D011739:Pyrimethamine