Randomized Clinical Trial of Azithromycin vs. Erythromycin for the Treatment of Chlamydia Cervicitis in Pregnancy

[摘要] Objective:The purpose of this study was to prospectively test the null hypothesis that there is nodifference in the clinical effectiveness of azithromycin and erythromycin for the treatment of chlamydiacervicitis in pregnancy.Methods:All antepartum obstetrical patients underwent routine screening for chlamydia cervicitisusing a DNA probe assay (Gen-Probe Pace, San Diego, CA). Women who tested positive forchlamydia cervicitis were prospectively randomized to receive either azithromycin 1 g orally atenrollment, or erythromycin 500 mg orally 4 times a day for 7 days. Sexual partners were referredto the county health department for evaluation and treatment. A test of cure was repeated in 2weeks. Results were analyzed by chi-square analysis and Fisher's exact test when indicated.Results:One hundred forty women tested positive for chlamydia cervicitis and agreed to randomization.There were 4 (6.2%) treatment failures in the azithromycin group and 18 (27.7%) inthe erythromycin group (P= 0.005). Gastrointestinal side effects were reported by 42 (65.5%) of thewomen taking erythromycin, but only 12 (19.4%) of those taking azithromycin (P< 0.002). Gastrointestinalside effects and resultant noncompliance were significantly related to treatment failurewith erythromycin.Conclusions:The findings of this study support the conclusion that a single dose of azithromycinis a significantly more effective and better tolerated treatment regimen for chlamydia cervicitis inpregnancy than erythromycin which is currently recommended.

[学科分类] 妇产科学