RESUMEN
OBJECTIVE: Our goal was to compare the efficacy of azithromycin with that of amoxicillin for the treatment of Chlamydia trachomatis infection during pregnancy. STUDY DESIGN: A randomized controlled trial of pregnant women with cervical C trachomatis infection receiving care at two inner-city, university-based prenatal clinics. Pregnant women were randomly assigned to receive either oral amoxicillin, 500 mg, three times daily for 7 days, or oral azithromycin, 1 g, in a single dose. Partners were referred for treatment. Tests of cure were scheduled 4 weeks after initiation of treatment. Statistical analysis was performed by using the Student t test and chi2 analysis. RESULTS: One hundred twenty-nine pregnant women were enrolled, and 110 (85%) completed the protocol. There was similar treatment efficacy between amoxicillin and azithromycin (58% vs 64%, respectively,P =.56). In the amoxicillin group 3 women (5.5%) were intolerant, compared with 6 (10.9%) in the azithromycin group (P =.31). CONCLUSION: Amoxicillin and azithromycin are equally efficacious in the treatment of cervical C trachomatis during pregnancy.
Asunto(s)
Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Azitromicina/uso terapéutico , Infecciones por Chlamydia/tratamiento farmacológico , Penicilinas/uso terapéutico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Adulto , Amoxicilina/efectos adversos , Antibacterianos/efectos adversos , Azitromicina/efectos adversos , Femenino , Humanos , Penicilinas/efectos adversos , Embarazo , Resultado del TratamientoRESUMEN
In their severest forms, pre-eclampsia and eclampsia may be life-threatening complications of pregnancy. We describe a patient with severe post-partum eclampsia characterized by seizures, deep coma, hypertension, renal insufficiency, coagulopathy, and microangiopathic hemolysis. The patient responded to treatment that included intensive plasma exchange, and she achieved full recovery. Our case supports the use of plasma exchange in patients with severe pre-eclampsia and eclampsia.