Interventions for treating genital chlamydia trachomatis infection in pregnancy

Cochrane Review by Brocklehurst P, Rooney G

This record should be cited as: Brocklehurst P, Rooney G. Interventions for treating genital chlamydia trachomatis infection in pregnancy. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD000054. DOI: 10.1002/14651858.CD000054.

ABSTRACT

Title

Interventions for treating genital chlamydia trachomatis infection in pregnancy

Background

Chlamydia trachomatis is a sexually transmitted infection. Mother-to-child transmission can occur at the time of birth and may result in ophthalmia neonatorum or pneumonitis in the newborn.

Objectives

The objective of this review was to assess the effects of antibiotics in the treatment of genital infection with Chlamydia trachomatis during pregnancy with respect to neonatal and maternal morbidity.

Search strategy

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006).

Selection criteria

Randomised trials of any antibiotic regimen compared with placebo or no treatment or alternative antibiotic regimens in pregnant women with genital Chlamydia trachomatis infection.

Data collection and analysis

Two review authors assessed trial quality and extracted data independently. Study authors were contacted for additional information.

Main results

Eleven trials were included. Trial quality was generally good. Amoxycillin appeared to be as effective as erythromycin in achieving microbiological cure (odds ratio 0.54, 95% confidence interval 0.28 to 1.02). Amoxycillin was better tolerated than erythromycin (odds ratio 0.16, 95% confidence interval 0.09 to 0.30). Clindamycin and azithromycin also appear to be effective, although the numbers of women included in trials are small.

Authors' conclusions

Amoxycillin appears to be an acceptable alternative therapy for the treatment of genital chlamydial infections in pregnancy when compared with erythromycin. Clindamycin and azithromycin may be considered if erythromycin and amoxycillin are contra-indicated or not tolerated.

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