Vol.64 No.3 May 2016
For outcome of chlamydial infection in obstetrics and gynecology
1)School of Nursing Division of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji Agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, Japan
2)Iwasaku Clinic
3)Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science
Abstract
We evaluated the efficacy of the treatment methods of Chlamydia trachomatis (CT) infection in the gynecological field, as recommended in the JAID/JSC Guide to the Clinical Management of Infectious Diseases 2014 and the 2011 Guidelines of Japanese Society for Sexually Transmitted Infection. Among 2,299 pregnant women who had a positive result in the CT screening test, 388 received acetylspiramycin (ASPM) 1,200 mg/day for 14 days, 209 received erythromycin (EM) 1,200 mg/day for 14 days, 129 received clarithromycin (CAM) 400 mg/day for 14 days and 1,519 received a single-dose administration of azithromycin (AZM) 1,000 mg. Cure of infection was assessed in all the patients in 2 to 3 weeks. Sixty-eight patients with CT-associated cervicitis and 24 patients with CT-associated pharyngitis received levofloxacin (LVFX) 500 mg/day for 7 days and underwent a polymerase chain reaction (PCR) examination 21 days later. In addition, among patients with CT-associated proctitis, 30 received a single-dose administration of AZM 2,000 mg and 9 received sitafloxacin (STFX) 100 mg/day for 7 days, in all of whom the rate of infection eradication was assessed 21 days later.
The bacterial eradication rate was high in all the groups of the pregnant women; 96.5% (375/388) in the ASPM group, 99% (207/209) in the EM group, 96.1% (124/129) in the CAM group and 99.6% (1,513/1,519) in the AZM group. No maternal infection was observed in any of the positive patients, who received treatment. The bacterial eradication rate was also high in the patients with CT-associated cervicitis who received LVFX (93.2%, 55/59) and CT-associated pharyngitis who received LVFX (95.8%, 23/24). The bacterial eradication rate in patients with CT-associated proctitis who received AZM was 86.7% (26/30), which was lower than that in the cervicitis group although AZM can migrate well into the rectum. On the other hand, the STFX bacterial eradication rate in the proctitis patients was 100% (7/7). From the results given above, we obtained extremely satisfactory results with almost all of the treatment methods of CT infections recommended in the gynecology guidelines except in those cases with CT-associated proctitis treated with AZM.
Key word
Chlamydia trachomatis infection, obstetrics and gynecology
Received
December 4, 2015
Accepted
January 5, 2016
Jpn. J. Chemother. 64 (3): 518-523, 2016
