Treatment of Chlamydia trachomatis infections in pregnant women

Drugs. 2000 Sep;60(3):597-605. doi: 10.2165/00003495-200060030-00006.


The intent of this article is to provide an overview of the epidemiology and pharmacotherapy, including cost analyses, of Chlamydia trachomatis infections in pregnant women. Chlamydia is a common sexually transmitted infection. For pregnant women, there are concerns both for the mother (post-partum endometritis, horizontal transmission) and the newborn (conjunctivitis, delayed pneumonia). Therapeutic options are restricted because of the fetus and include multi-day treatment with erythromycin, amoxicillin, clindamycin or single dose azithromycin. Clinical cure rates with these options are 86, 92, 93 and 95%, respectively. Pharmacoeconomic analyses have been conducted to determine if the initial increase in acquisition cost of azithromycin (approximately 3-fold higher than erythromycin or amoxicillin) is offset by improvement in compliance and drug efficacy. Clindamycin has received little attention because of its expense (4-fold more than azithromycin). Analyses have been retrospective. As models incorporate more complications of failure to cure, azithromycin increasingly becomes more cost effective and is our recommended treatment.

MeSH terms

  • Adult
  • Amoxicillin / economics
  • Amoxicillin / therapeutic use*
  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / economics
  • Azithromycin / therapeutic use*
  • Chlamydia Infections / drug therapy*
  • Chlamydia trachomatis*
  • Clindamycin / economics
  • Clindamycin / therapeutic use*
  • Cost-Benefit Analysis
  • Drug Costs
  • Female
  • Humans
  • Middle Aged
  • Patient Compliance
  • Penicillins / economics
  • Penicillins / therapeutic use*
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Retrospective Studies


  • Anti-Bacterial Agents
  • Penicillins
  • Clindamycin
  • Amoxicillin
  • Azithromycin