SINGLE-DOSE AZITHROMYCIN FOR CHLAMYDIA IN PREGNANT-WOMEN

OBJECTIVE: To assess the efficacy and occurrence of severe side effect s associated with the use of a single dose of azithromycin in the trea tment of Chlamydia trachomatis in pregnant women. STUDY DESIGN: Patien ts and their sexual partners were randomized into three treatment grou ps: both the patient and her sexual partner received a single dose of azithromycin (group 1); the patient was given a standard course of ery thromycin, while her partner was given a standard course of tetracycli ne (group 2); and the patient was given a single dose of azithromycin with the sexual partner given a standard course of tetracycline (group 3). Group 3 was included in order to assess the relative efficacy of tetracycline with re spect to the use of azithromycin among patients a nd to indirectly assess possible patient reinfection by sexual partner s. RESULTS: With respect to the cure rate, 4.5% of study participants given azithromycin has positive cultures vs. 21.1% of patients given e rythromycin or tetracycline (P = .018). With respect to side effects s evere enough to warrant a change in medication, 7.4% of patients recei ving azithromycin reported suffering such side effects vs. 38.8% of pa tients given erythromycin (P = .02). Among sexual partners, 28.6% give n tetracycline reported severe side effects vs. none of those given az ithromycin (P = .03). CONCLUSION: Azithromycin in the treatment of C t rachomatis in pregnant women substantially improved the cure rates whi le substantially reducing the occurrence of severe side effects associ ated with the use of a standard course of erythromycin. Since both tet racycline and erythromycin are known to be effective against C trachom atis infection, the improved efficacy of azithromycin is probably due to noncompliance with the multidose, multiday regimen associated with the use of these two antibiotics.