The Efficacy of Antibiotics in the Treatment of Chlamydia Trachomatis Infections during Pregnancy. A Systematic Review and a Meta-analysis.

Abstract

Chlamydia trachomatis infections encountered during pregnancy can lead to many complications for both mother and neonate if left untreated. A systematic review and a meta-analysis were conducted to analyse the efficacy of antibiotic treatment infection during pregnancy that established the most effective antibiotic to treat Chlamydia trachomatis infections during pregnancy. PubMed and Cochrane Library were searched to the end of 2019. Randomised control trials that aligned with inclusion criteria of relevant antibiotics Azithromycin, Erythromycin, Clindamycin and Amoxicillin during Pregnancy was included. A systematic review and meta-analysis were used to calculate pooled (i) success of treatment for each antibiotic in several trials and (ii) the total adverse side effects for each drug encountered in several trials. Randomised controlled trials (RCTs) selected included 1917 pregnant patients with Chlamydia infections, and 851 have completed follow up assessments. Data from three RCTs observed a higher success of treatment for Azithromycin versus Erythromycin, fixed effect model, odds ratio (OR) = 0.67, 95% confidence interval (CI), 0.32-1.80. Data from three RCTs observed a higher success of treatment for Clindamycin versus Erythromycin OR = 2.43 95%, CI:2.00-2.60. Data from two RCTs showed a higher success of treatment for Amoxicillin versus Erythromycin OR = 3.74, 95%, CI:0.68-13.66. Analysis established that Erythromycin resulted in the most adverse side effects. Azithromycin was determined as the most effective antibiotic to treat C. trachomatis infections during pregnancy due to the high success of treatment. Clindamycin is capable of eradicating C. trachomatis infections in pregnancy and can be considered a secondary antibiotic treatment with fewer incidences of adverse side effects and high levels of successful treatment of the infection, however, due to a lack of studies more analysis will be required to confirm the efficacy of Clindamycin.