AMOXICILLIN OR ERYTHROMYCIN FOR THE TREATMENT OF ANTENATAL CHLAMYDIALINFECTION - A METAANALYSIS

Objective: To compare the effectiveness of amoxicillin and erythromyci n for the treatment of antenatal. Chlamydia trachomatis infection by m eta-analysis of available trials involving random assignment of subjec ts. Data Sources: A computer search of English-language abstracts usin g MEDLINE and the Cochrane Pregnancy and Childbirth Database (medical subject heading terms: pregnancy, chlamydia, erythromycin, amoxicillin , antenatal antibiotics) was supplemented with a review of the bibliog raphies of the relevant articles generated by the computer search. Met hods of Study Selection: Five trials were identified, four of which me t our inclusion criteria for the metaanalysis. Data Extraction and Syn thesis: Trials to be included in this meta-analysis underwent trial qu ality evaluation and data abstraction. An estimate of the relative ris k (RR) was calculated for the dichotomous outcomes using a fixed-effec ts model. The pooled RR for the effectiveness of amoxicillin compared with erythromycin was 1.11 (95% confidence interval [CI] 1.05-1.18), a nd the pooled RR for gastrointestinal side effects of amoxicillin comp ared with erythromycin was 0.29 (95% CI 0.20-0.42). The pooled RR for gastrointestinal side effects that resulted in discontinuation of ther apy of amoxicillin compared with erythromycin was 0.14 (95% CI 0.06-0. 36). Conclusion: The available data suggest that amoxicillin is more e ffective than erythromycin for the treatment of antenatal C trachomati s infection and has fewer gastrointestinal side effects, leading to be tter compliance.