RANDOMIZED COMPARISON OF AMOXICILLIN ACID ERYTHROMYCIN IN TREATMENT OF GENITAL CHLAMYDIAL INFECTION IN PREGNANCY

Erythromycin, the standard treatment for chlamydial infection in pregn ant women, commonly causes side-effects, which limits its efficacy. In a randomised, double-blind study, we compared amoxycillin with erythr omycin in this setting. 210 pregnant women with Chlamydia trachomatis infection were randomly assigned 7 days' treatment with amoxycillin (5 00 mg three times daily) or erythromycin (500 mg four times daily). Co ntrol cultures were obtained 21 days after treatment, during late preg nancy, and from the infant within a week of birth. Treatment was judge d a failure if any post-treatment culture was positive or if the patie nt had to stop therapy because of severe side-effects. 11 women (5.2%) were lost to follow-up. 1 (of 100) amoxycillin-treated women had to s top treatment because of severe side-effects compared with 12 (of 99) erythromycin-treated women (p=0.002). 1 woman in the amoxycillin group had a positive culture at the third-trimester examination. No positiv e post-treatment culture was found in the erythromycin group. Severe g astrointestinal side-effects were more common in women who received er ythromycin (31 vs 6%, p<0.001). The overall failure rate was therefore 2% in the amoxycillin group and 12% in the erythromycin group (p=0.00 5). These results suggest that amoxycillin is an acceptable alternativ e to erythromycin for C trachomatis infection in, pregnant women.