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Interventions for treating genital Chlamydia trachomatis infection in pregnancy

Cluver, Catherine ; Novikova, Natalia ; Eriksson, David O. A. ; Bengtsson, Kevin ; Lingman, Goran K. (2017)

CITATION: Cluver, C., et al. 2017. Interventions for treating genital Chlamydia trachomatis infection in pregnancy. Cochrane Database of Systematic Reviews, 9:1-69, Art. CD010485, doi:10.1002/14651858.CD010485.pub2.

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Background: Genital Chlamydia trachomatis (C.trachomatis) infection may lead to pregnancy complications such as miscarriage, preterm labour, low birthweight, preterm rupture of membranes, increased perinatal mortality, postpartum endometritis, chlamydial conjunctivitis and C.trachomatis pneumonia.This review supersedes a previous review on this topic. Objectives: To establish the most efficacious and best‐tolerated therapy for treatment of genital chlamydial infection in preventing maternal infection and adverse neonatal outcomes. Selection criteria: Randomised controlled trials (RCTs) as well as studies published in abstract form assessing interventions for treating genital C.trachomatis infection in pregnancy. Cluster‐RCTs were also eligible for inclusion but none were identified. Quasi‐randomised trials and trials using cross‐over design are not eligible for inclusion in this review. Data collection and analysis: Two review authors independently assessed studies for inclusion, assessed trial quality and extracted the data using the agreed form. Data were checked for accuracy. Evidence was assessed using the GRADE approach. Main results: We included 15 trials (involving 1754 women) although our meta‐analyses were based on fewer numbers of studies/women. All of the included studies were undertaken in North America from 1982 to 2001. Two studies were low risk of bias in all domains, all other studies had varying risk of bias. Four other studies were excluded and one study is ongoing. Eight comparisons were included in this review; three compared antibiotic (erythromycin, clindamycin, amoxicillin) versus placebo; five compared an antibiotic versus another antibiotic (erythromycin, clindamycin, amoxicillin, azithromycin). No study reported different antibiotic regimens.

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