A Randomized Trial of Azithromycin Versus Amoxicillin for theTreatment ofChlamydia trachomatisin pregnancy

[摘要] Objective:To compare the compliance, side effects and efficacy of amoxicillin and azithromycin for the treatmentofChlamydia trachomatisinfection in pregnancy.Methods:This is a randomized single-blind trial of women diagnosed withC. trachomatisbefore 33 weeksgestation.Women were randomly assigned either 500 mg amoxicillin orally three times per day for 7 days or a singledose of 1 g azithromycin orally. Patientswere interviewed by telephone approximately 3–7 days following therapyto assess compliance and side effects. Test of cure was performed at a follow-up visit 4–6 weeks following completionof therapy.Results:Thirty-nine patients were randomized with 19 receiving amoxicillin and 20 receiving azithromycin. Therewere no differences in baseline data between the two groups, and there were no statistically significant differencesin side effects, compliance or efficacy. In the amoxicillin group 84% of women took all pills, while 100% completedthe single 1 g dose of azithromycin. Side effects were common in both groups (38% overall), with 40% of theazithromycin group reporting moderate to severe gastrointestinal side effects compared to 17% in the amoxicillingroup (p= 0.11). Of patients who returned for follow-up test of cure, 3 of 15 (20%) in the amoxicillin group werepositive compared with 1 of 19 (5%) in the azithromycin group (p= 0.3).Conclusions:Side effects of therapy forC. trachomatisin pregnancy are common. Amoxicillin was slightly bettertolerated than azithromycin. Compliance and cure rates with both regimens was high.

[学科分类] 妇产科学