Amoxicillin therapy for chlamydia trachomatis in pregnancy

Article Abstract:

Chlamydia trachomatis, the most common sexually transmitted bacteria, can infect both men and women. In women, the bacteria can cause swelling in the cervix (cervicitis) and other reproductive structures located in the pelvis (pelvic inflammatory disease, PID). This organism is also associated with pregnancies implanting in areas outside of the uterus (ectopic pregnancies) and infertility. Fetuses can become infected when the bacteria travel upward from the cervix to the uterus. Fetuses born to mothers with chlamydial infections are at risk for lung and eye infections after birth. Although treating pregnant women who were in their 36th week of pregnancy with erythromycin either cured or prevented transmission to the fetus, intestinal side effects were severe enough to discontinue its use. Since an antibiotic is only good if all the medication is taken, poor patient compliance limits its effectiveness. Amoxicillin was evaluated as an alternative treatment for women intolerant or allergic to erythromycin. The efficacy and patient tolerance of erythromycin (500 milligrams four times a day for seven days) and amoxicillin (500 mg three times a day for seven days) were compared among mothers with chlamydial infections. Erythromycin was given to 100 women and amoxicillin was given to 93 women. Cervical cultures were negative in 63 out of 64 (98.4 percent) of the amoxicillin-treated women attending follow-up and 55 out of 58 (94.8 percent) of the erythromycin-treated mothers. Chlamydia failed to be transmitted to the fetus in 37 out of 39 (94.9 percent) amoxicillin-treated mothers and 32 out of 36 (88.8 percent) erythromycin-treated mothers. The difference between the two treatment groups was not statistically significant. Side effects such as nausea, diarrhea, itching, dizziness and rash were experienced by eight patients in the amoxicillin-treated group (8.6 percent), two of whom discontinued therapy. Nausea, cramping and vomiting were experienced by 15 women receiving erythromycin, 13 of whom discontinued therapy. Although erythromycin is the drug of choice in treating infection with Chlamydia trachomatis during pregnancy, amoxicillin therapy can be an acceptable treatment alternative. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Erythromycin, Pregnancy, Complications of, Pregnancy complications, Chlamydia infections, Fetal diseases, Amoxicillin

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Comparison of cefotetan plus doxycycline with cefoxitin plus doxycycline in the inpatient treatment of acute salpingitis

Article Abstract:

Acute salpingitis, or inflammation of the female pelvic region, can lead to sterility, chronic pain, and other serious problems. This condition is more commonly known as pelvic inflammatory disease (PID). Although increases in the rate of PID have paralleled increases in sexually transmitted diseases (STDs), the exact cause of PID is unknown. However, a number of bacteria are known to be associated with its occurrence. The Centers for Disease Control (CDC) has recommended combination antibiotic therapy to destroy the various bacteria found in women with this condition. To evaluate the effectiveness of combination therapy, 115 women with acute salpingitis were assessed. They were examined and randomly assigned to one of two treatment groups; group I received cefotetan and doxycycline and group II was given cefoxitin and doxycycline. Results showed that 108 subjects completed the study, 54 in each treatment group. A total of 507 bacterial organisms were isolated from 101 of the women. Neisseria gonorrhoeae, the most commonly identified organism, was isolated from 72 (67 percent) of the patients. Successful clinical responses to drug therapy occurred in 51 of 54 women (94 percent) in each group. Duration of treatment was similar for both groups, and few drug side effects occurred in either group. These results indicate that both drug regimens are highly effective and safe in treating acute salpingitis. Further studies are required to determine if either combination of antibiotics has any long-term side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Combination, Combination drug therapy, Doxycycline, Cefotetan, Cefoxitin

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Does addition of anti-inflammatory agents to antimicrobial therapy reduce infertility after murine chlamydial salpingitis?

Article Abstract:

No additional treatment benefit is gained from the use of anti-inflammatories in conjunction with antibiotics in the treatment of chlamydia-induced salpingitis in mice. Chlamydia is one of the most common sexually transmitted diseases in humans and can result in female infertility when secondary infections of the Fallopian tubes, such as salpingitis, occur. Mice infected with Chlamydia trachomatis experienced a higher cure rate when antibiotic tetracycline treatment was started within two days of infection. When antibiotic therapy was started five days after infection there was less risk of infertility than if no treatment was given but more than if treatment had started earlier. The use of anti-inflammatory ibuprofen, prostaglandin E and hydrocortisone drugs alone produced no cure and led to infertility. The use of anti-inflammatories in combination with antibiotics had no effect on treatment success rate. More research will have to be done to determine the optimal time to begin treatment of women.

Ibuprofen, Hydrocortisone, Tetracycline, Tetracyclines, Prostaglandins E

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