Amoxicillin or erythromycin for the treatment of antenatal chlamydial infection: a meta-analysis

Obstet Gynecol. 1995 Dec;86(6):1021-5. doi: 10.1016/0029-7844(95)00296-4.

Abstract

Objective: To compare the effectiveness of amoxicillin and erythromycin for the treatment of antenatal Chlamydia trachomatis infection by meta-analysis of available trials involving random assignment of subjects.

Data sources: A computer search of English-language abstracts using MEDLINE and the Cochrane Pregnancy and Childbirth Database (medical subject heading terms: pregnancy, chlamydia, erythromycin, amoxicillin, antenatal antibiotics) was supplemented with a review of the bibliographies of the relevant articles generated by the computer search.

Methods of study selection: Five trials were identified, four of which met our inclusion criteria for the meta-analysis.

Data extraction and synthesis: Trials to be included in this meta-analysis underwent trial quality evaluation and data abstraction. An estimate of the relative risk (RR) was calculated for the dichotomous outcomes using a fixed-effects model. The pooled RR for the effectiveness of amoxicillin compared with erythromycin was 1.11 (95% confidence interval [CI] 1.05-1.18), and the pooled RR for gastrointestinal side effects of amoxicillin compared with erythromycin was 0.29 (95% CI 0.20-0.42). The pooled RR for gastrointestinal side effects that resulted in discontinuation of therapy of amoxicillin compared with erythromycin was 0.14 (95% CI 0.06-0.36).

Conclusion: The available data suggest that amoxicillin is more effective than erythromycin for the treatment of antenatal C trachomatis infection and has fewer gastrointestinal side effects, leading to better compliance.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Amoxicillin / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use*
  • Chlamydia Infections / drug therapy*
  • Chlamydia trachomatis*
  • Clinical Trials as Topic
  • Erythromycin / therapeutic use*
  • Female
  • Humans
  • Penicillins / therapeutic use*
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*

Substances

  • Anti-Bacterial Agents
  • Penicillins
  • Erythromycin
  • Amoxicillin