Randomized Prospective Study Comparing Erythromycin, Amoxicillin, and Clindamycin for theTreatment ofChlamydia trachomatisin Pregnancy

[摘要] Objective:The purpose of this study was to compare the efficacy and side effects of erythromycin,amoxicillin, and clindamycin in eradicatingChlamydia trachomatisfrom the lower genital tract ofpregnant women.Methods:A total of 174 women at <36 weeks gestation with positive cervical cultures forC.trachomatiswere enrolled. Patients were assigned in a randomized prospective fashion to eithererythromycin (500 mg q.i.d, for 7 days), amoxicillin (500 mg t.i.d, for 7 days), or clindamycin (600 mgt.i.d, for 10 days). Six women elected not to participate and 8 patients were lost to follow-up, leaving53 patients in the erythromycin group, 55 patients in the amoxicillin group, and 52 patients in theclindamycin group. All sexual partners of the enrolled women were offered doxycycline (100 mgb.i.d. for 7 days) and patients were instructed to use barrier contraception until treatment wascomplete.Results:All 3 medications were effective agents for the treatment of antenatalC. trachomatisinfection with treatment efficacies of 96%, 94%, and 98% for the erythromycin, amoxicillin, andclindamycin groups, respectively. When the antibiotic groups were compared, no statistically significantdifferences were noted in intolerance. However, the differences in the incidence of gastrointestinalsymptoms between erythromycin and amoxicillin and/or clindamycin were significant(P < 0.05).Conclusions:These findings suggest that 1) all 3 antibiotic regimens are efficacious, 2) erythromycinhas a higher incidence of side effects, and 3) amoxicillin or clindamycin are reasonable alternativesfor the treatment ofC. trachomatisin pregnant patients unable to tolerate erythromycin.

[学科分类] 妇产科学