CHLAMYDIA IN PREGNANCY - A RANDOMIZED TRIAL OF AZITHROMYCIN AND ERYTHROMYCIN

Objective: To determine side effect profiles and cure rates of azithro mycin compared with erythromycin in the treatment of chlamydial cervic itis complicating pregnancy. Methods: Pregnant patients with positive DNA antigen assays for Chlamydia trachomatis were randomized to either azithromycin, Ig oral slurry in a single dose, or erythromycin, 500 m g every 6 hours for 7 days. Repeat assays were planned for 3 weeks aft er therapy. Side effects, compliance, and treatment efficacy were asse ssed. Results: One hundred six women were enrolled, and eighty-five wo men completed the protocol. Significantly fewer gastrointestinal side effects were noted in the azithromycin group than in the erythromycin group (11.9% versus 58.1%, P less than or equal to .01). Enhanced comp liance was noted with azithromycin, because it was given in a single o bserved dose. Similar treatment efficacy was noted between azithromyci n and erythromycin (88.1% versus 93.0%, P > .05). Conclusion: Compared with erythromycin, azithromycin is associated with significantly fewe r gastrointestinal side effects in pregnancy. This association, along with the ease of administration and similar efficacy, suggests that az ithromycin should be considered for the initial treatment of chlamydia l cervicitis in pregnancy. (C) 1998 by The American College of Obstetr icians and Gynecologists.