Comparative efficacy of clindamYcin versus erythromycin in eradication of antenatal Chlamydia trachomatis

Alger, Lindsay S.

doi:10.1016/0002-9378(91)90097-b

Cited by 30 publications

(14 citation statements)

References 17 publications

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“…While some investigators have reported cure rates in pregnancy of 98% with 1,500 mg of amoxicillin daily for 7 days, 20 and 95% with 1,000 mg of clindamycin daily for 14 days, 21 cure rates with erythromycin seem to be more variable, perhaps related to gastrointestinal tolerance and, in turn, to non-compliance. 20 C. trachomatis cure rates after erythromycin have ranged from 92 to 95% with 1,600-2,000 mg daily doses for 7 days 20,22 to 76-88% with 1,000-2,000 mg daily doses for 7-14 days.…”

Section: Discussionmentioning

confidence: 85%

“…20 C. trachomatis cure rates after erythromycin have ranged from 92 to 95% with 1,600-2,000 mg daily doses for 7 days 20,22 to 76-88% with 1,000-2,000 mg daily doses for 7-14 days. 11,21 Direct comparisons of 1,000 vs. 2,000 mg daily doses of erythromycin have not been performed during pregnancy, but in non-pregnant women, one study has suggested that the 1,000 mg dose appears to be less effective than the 2,000 mg daily dose. C. trachomatis was recovered after therapy in 27% of 45 non-pregnant women given 1,000 mg and 10% of 31 nonpregnant women given 2,000 mg. 23 The low recovery rate in the placebo group was unexpected since other studies have shown that C. trachomatis persists in 85-90% of untreated non-pregnant 23,24 and 71-75% of untreated pregnant women.…”

Section: Discussionmentioning

confidence: 98%

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Double-blind placebo-controlled treatment trial ofChlamydia trachomatis endocervical infections in pregnant women

Martín

Eschenbach

Cotch

et al. 1997

Infect. Dis. Obstet. Gynecol.

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Objective: The purpose of this study was to determine if treatment of pregnant women with Chlamydia trachomatis infection would lower the incidence of preterm delivery and/or low birth weight.Methods: Pregnant women between the 23rd and 29th weeks of gestation were randomized in double-blind fashion to receive either erythromycin 333 mg three times daily or an identical placebo.The trial continued until the end of the 35th week of gestation.Results: When the results were examined without regard to study site, erythromycin had little impact on reducing low birth weight (8% vs. 11%, P 0.4) or preterm delivery (13% vs. 15%, P 0.7). At the sites with high persistence of C. trachomatis in the placebo-treated women, low birth weight infants occurred in 9 (8%) of 114 erythromycin-treated and 18 (17%) of 105 placebo-treated women (P 0.04) and delivery <37 weeks occurred in 15 (13%) of 115 erythromycin-treated and 18 (17%) of 105 placebo-treated women (P 0.4).Conclusions: The results of this trial suggest that the risk of low birth weight can be decreased by giving erythromycin to some women with C. trachomatis. Due to the high clearance rate of C.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 98%

Double-blind placebo-controlled treatment trial ofChlamydia trachomatis endocervical infections in pregnant women

Martín

Eschenbach

Cotch

et al. 1997

Infect. Dis. Obstet. Gynecol.

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“…Clindamycin is an alternative to erythromycin for the treatment of C trachomatis cervicitis in pregnancy (33). Of 126 patients randomized to clindamycin 450 mg qid or erythromycin 333 mg qid, each for 14 days or to placebo, short term eradication was achieved in 93% versus 84% of clindamycin-or erythromycin-treated patients (not significant).…”

Section: Gynecological Infectionsmentioning

confidence: 96%

Current Indications for the Use of Clindamycin: A Critical Review

Śmieja

1998

Canadian Journal of Infectious Diseases and Medical Microbiolog

103

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OBJECTIVES:To review the literature and develop evidence-based guidelines for the use of the antibiotic clindamycin. DATA SOURCES: A search of the MEDLINE database for randomized clinical trials, cohort studies and review articles that examine the therapeutic use or potential adverse effects of clindamycin was undertaken for the years 1966 to 1996. In addition, relevant citations obtained from the references cited in the identified reviews, book chapters and antibiotic guidelines were included. DATA EXTRACTION: Selected articles examining the indications for or adverse effects from the prophylactic or therapeutic use of clindamycin were selected. A level of evidence was assigned to the indication according to published criteria. DATA SYNTHESIS AND CONCLUSIONS: Randomized clinical trials (level 1 evidence) support the use of clindamycin in a number of common conditions, including preoperative prophylaxis, intra-abdominal infections, recurrent group A streptococcal pharyngitis, Chlamydia trachomatis cervicitis and anaerobic lung infections. Cohort studies (level 2 evidence) support the use of clindamycin for bone and soft tissue infections. Expert opinion (level 3 evidence) supports the use of clindamycin for invasive group A streptococcal infection and the treatment of diabetic foot infections. Clindamycin's disadvantages are its high cost, the common occurrence of rash and the predisposition of patients taking clindamycin to Clostridium difficile-associated colitis. Based on cohort studies, the risk of severe diarrhea in out-patients is as low as one per 1000, but the risk of in-patients acquiring C difficile colonization may be as high as 30%.

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“…Non-compliance with antibiotic therapy for acute community-acquired infections is widespread [1] and can impact treatment effectiveness, with reductions in clinical success rates of between 16% and 52% [2][3][4][5][6][7][8][9], impacting health-related quality of life [10].…”

Section: Introductionmentioning

confidence: 99%

Non-compliance with antibiotic therapy for acute community infections: a global survey

Péchère¹,

Hughes²,

Kardas³

et al. 2007

International Journal of Antimicrobial Agents

115

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Comparative efficacy of clindamYcin versus erythromycin in eradication of antenatal Chlamydia trachomatis

Cited by 30 publications

References 17 publications

Double-blind placebo-controlled treatment trial ofChlamydia trachomatis endocervical infections in pregnant women

Double-blind placebo-controlled treatment trial ofChlamydia trachomatis endocervical infections in pregnant women

Current Indications for the Use of Clindamycin: A Critical Review

Non-compliance with antibiotic therapy for acute community infections: a global survey

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