Double-blind randomized study comparing amoxicillin and erythromycin for the treatment of Chlamydia trachomatis in pregnancy.

Abstract

OBJECTIVE:

To compare the efficacy and patient tolerance of amoxicillin to that of erythromycin in the treatment of lower genital tract chlamydia infections during pregnancy.

METHODS:

A double-blind, randomized study was conducted comparing oral amoxicillin 500 mg three times daily versus oral erythromycin 500 mg four times daily for 7 days. One hundred forty-three women with positive cervical cultures for chlamydia at less than 36 weeks' gestation were enrolled. A test-of-cure culture was obtained 4 weeks after entry into the study and side effects were assessed. Success of the regimen was defined as completing the course of medication and having a negative test-of-cure culture.

RESULTS:

Thirty of the 65 women in the erythromycin group (46.1%) developed symptoms while taking the medication and 15 of them were unable to continue treatment (23.1%). In contrast, five of the 65 women (7.7%) in the amoxicillin group became symptomatic, with only one of these patients intolerant of the side effects (1.5%) (P < .001). Of the 50 patients in the erythromycin group who were able to complete their course of medication, only three had a positive test of cure (6.0%). In comparison, nine of the 64 patients (14.1%) taking amoxicillin who completed their course had positive cultures at test of cure. This difference was not statistically significant (P = .14). Forty-seven of the 65 patients (72.3%) in the erythromycin group successfully completed their regimen, compared to 55 of the 65 women (84.6%) in the amoxicillin group. This difference was not statistically significant.

CONCLUSIONS:

These findings suggest that amoxicillin is a reasonable alternative for the treatment of chlamydia in pregnant patients intolerant to erythromycin. The incidence of side effects and intolerance to therapy for amoxicillin are less than those for erythromycin.

• Authors: A H Magat, L S Alger, D A Nagey, V Hatch, J C Lovchik
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 81 Issue 5 ( Pt 1) Pg. 745-9 (May 1993) ISSN: 0029-7844 [Print] United States
• PMID: 8469466 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Erythromycin
• Amoxicillin

Topics

• Adult
• Amoxicillin (adverse effects, therapeutic use)
• Chlamydia Infections (drug therapy)
• Chlamydia trachomatis
• Double-Blind Method
• Drug Administration Schedule
• Erythromycin (adverse effects, therapeutic use)
• Female
• Humans
• Pregnancy
• Pregnancy Complications, Infectious (drug therapy)