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Infect Dis Obstet Gynecol. 2001; 9(4): 197–202. doi: 10.1155/S1064744901000321. | PMCID: PMC1784654 |
Copyright © 2001 Hindawi Publishing Corporation. A Randomized Trial of Azithromycin Versus Amoxicillin for the
Treatment of Chlamydia trachomatis in pregnancy Jennifer Kacmar, Emily Cheh, Andrea Montagno, and Jeffrey F. Peipert  Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, 101 Dudley Street, Providence, RI, 02905, USA, Received May 30, 2001; Accepted October 5, 2001. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective: To compare the compliance, side effects and efficacy of amoxicillin and azithromycin for the treatment
of Chlamydia trachomatis infection in pregnancy. Methods: This is a randomized single-blind trial of women diagnosed with C. trachomatis before 33 weeks
gestation.Women were randomly assigned either 500 mg amoxicillin orally three times per day for 7 days or a single
dose of 1 g azithromycin orally. Patientswere interviewed by telephone approximately 3–7 days following therapy
to assess compliance and side effects. Test of cure was performed at a follow-up visit 4–6 weeks following completion
of therapy. Results: Thirty-nine patients were randomized with 19 receiving amoxicillin and 20 receiving azithromycin. There
were no differences in baseline data between the two groups, and there were no statistically significant differences
in side effects, compliance or efficacy. In the amoxicillin group 84% of women took all pills, while 100% completed
the single 1 g dose of azithromycin. Side effects were common in both groups (38% overall), with 40% of the
azithromycin group reporting moderate to severe gastrointestinal side effects compared to 17% in the amoxicillin
group (p = 0.11). Of patients who returned for follow-up test of cure, 3 of 15 (20%) in the amoxicillin group were
positive compared with 1 of 19 (5%) in the azithromycin group (p = 0.3). Conclusions: Side effects of therapy for C. trachomatis in pregnancy are common. Amoxicillin was slightly better
tolerated than azithromycin. Compliance and cure rates with both regimens was high. The Full Text of this article is available as a PDF (109K). These references are in PubMed. This may not be the complete list of references from this article. - Andrews WW, Goldenberg RL, Mercer B, Iams J, Meis P, Moawad A, Das A, Vandorsten JP, Caritis SN, Thurnau G, Miodovnik M, Roberts J, McNellis D. The Preterm Prediction Study: association of second-trimester genitourinary chlamydia infection with subsequent spontaneous preterm birth. Am J Obstet Gynecol. 2000 Sep;183(3):662–668. [PubMed]
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