Don’t be surprised!Amoxicillin is also an old star who treats pregnant women with chlamydia infection

Author: Zhong Yuechun, the clinical pharmacist of Huizhou Central People’s Hospital

Recently, Zhong Yaoshi received a consultation phone call, saying that a pregnant woman diagnosed chlamydia in the locho, but was allergic to Achicillin. Is there any other alternative drug for consultation?

As we all know, Azithromycin is the preferred drug for the treatment of chlamydia and mycoplasma infection for pregnant women. It is safe to use during pregnancy, but what should I do if I can’t use Achicillin for treatment?At this time, another low -key old star drug infected with chlamydia infected by pregnant women should be on the stage. Let’s look down quickly.

The chlamydia of the trachoma is a proximal cell microorganism in the cells. According to its main exterior protein, it is divided into A ~ L serum type. Among them, A ~ C serum type mainly causes eye infection. The D ~ K serum type mainly causes genital tract infections.L1 ~ L3 serum type mainly causes sexually transmitted lymph granuloma.

Among them, the rotor of the reproductive tract sandy is mainly transmitted through sex. If it is not treated in time after infection, it can cause pelvic inflammatory disease, cervicitis, ectopic pregnancy, and infertility.

In addition, the primary chlamydia of the reproductive tract can also be transmitted between maternal and infants through intrauterine infection and birth canal infection, which can cause abortion, premature birth, newborns infection, etc.Therefore, when pregnant women infected with chlamydia, they should be actively treated to reduce the occurrence of complications during pregnancy and reduce vertical transmission between mothers and infants.

For adult patients (except for pregnant women), the preferred choice Azithromycin or poisotin is recommended. The second -tier therapy drugs include erythromycin, erythromycin, losiconin, or levofofloxacin.For pregnant women, the safety needs to be evaluated during pregnancy. Among the above drugs, tetracycline drugs such as doxyin can cause dysteutone drugs such as fetal enamel dysplasia, Positive or Levofloxacin, etc.Pregnant women should be avoided.

Therefore, the chlamydia infection of pregnant women is still recommended to prefer Azithromycin. The second -tier therapy drugs are erythromycin, alopotromycin, but erythromycin, alter erythromycin, and Akithromycin are the same as large ring.EssenceThroughout the domestic and foreign treatment guidelines (see the table below), the treatment of the chlamydia in the treatment of pregnant women also recommend this star drug -amoxicillin.

guide

Recommendation plan

alternative plan

Guidelines for the treatment of chlamydia infection of sandylona coat in the American Centers for Disease Control (2010)

Achicillin 1g, a single meal; or 500 mg of gorbinomycin, orally, 3 times/d, a total of 7D.

Erythromycin 0.5g 4 times a day, a total of 7D, or 0.25g of erythromycin, 4 times a day, a total of 14d; erythromycin 800 mg, orally, 4 times a day, a total of 7D, or alumhrine, or Ao and BiErythromycin 400 mg, orally, 4 times a day, a total of 14D.

"Guidance for Pregnant Women’s Medicine for Breastfeeding Women", People’s Health Press, (2012)

Achicycin 1g, single -agent orally, or 0.5g of amoxicillin, 3 times a day, a total of 7D.

Erythromycin 0.5g 4 times a day, a total of 7D, or erythromycin 0.25g, 4 times a day, a total of 14d;

Symelona, gonorrhea and reproductive tract Sandoma chlamydia infection diagnosis and treatment guidelines (2014)

Achicycin 1g, single -agent orally, or 0.5g of amoxicillin, 3 times a day, a total of 7D.

Erythromycin 0.5g 4 times a day, a total of 7D, or 0.25g of erythromycin, 4 times a day, a total of 14D.

Guidelines for the diagnosis and treatment of disease control centers of the American Disease Control (2015)

Achicillin 1g, a single meal.

Amoxicillin 500mg, oral, 3 times/d, a total of 7D or erythromycin 500mg, orally, 4 times/d, a total of 7D or erythromycin 250mg, oral, 4 times/d, a total800 mg of moldin, orally, 4 times/d, a total of 7D or alidin 400 mg, oral, 4 times/d, a total of 14D.

Female reproductive tract Sandoma chlamydia infection and treatment consensus (2015)

Achicillin 1g, a single meal.

Erythromycin 0.5g 4 times a day, a total of 7D, or 0.25g of erythromycin, 4 times a day, a total of 14D.If pregnant women cannot apply large -ringing drugs, some documents show that amoxicillin may be effective.

Who Guidelines for the Treatment of Chlamydia Trachomatis (2016)

Achicillin 1g, a single meal.

Amoxicillin 0.5g 3 times a day, a total of 7D or erythromycin 500mg, 2 times/d, a total of 7D.

Symelona, gonorrhea and reproductive tract Sandoma chlamydia infection diagnosis and treatment guidelines (2020)

Azithromycin 1g on the 1st, 0.5g daily on the 2nd; or 0.5g of amoxicillin 3 times a day for a total of 7D.

Erythromycin 0.5g 4 times a day, a total of 10-14D

It can be seen that as early as ten years ago, Amosirin had been recommended to treat the chlamydia infection of pregnant women, which can break our understanding of Amoxicillin.

It is also called hydroxylinancin, which belongs to penicillin antibacterial drugs. It is currently commonly used in the treatment of infection caused by the treatment of Gram -positive bacteria and Gram -negative bacteria.In fact, as early as 1977, foreign scholars discovered that penicillin could inhibit the normal growth of the chlamydia of the sandylona. After that, a large number of forward -looking research results showed that the preliminaries of pregnant women infected with the primary treatment of the sacked coat can be given to amoxicillin.EssenceIn terms of clinical efficacy, comparison with erythromycin or erythromycin and amoxicillin compared with erythromycin. The clinical treatment success rate has no significant difference. Achicillin cure rate is 63 ~ 100%, and amoxicillin cure rate is 58 ~ 80%, red mold, and red mold.The cure rate is 72 ~ 94%, but amoxicillin’s overall adverse reactions are significantly lower than erythromycin.

Therefore, in 2003, the Guidelines for Sexual Communication infection developed by the World Health Organization began to recommend A Mo Xilin for the treatment of chlamydia in maternal sacked mulf.Since there is such a good clinical efficacy, what is the mechanism of Anglin’s treatment of chlamydia of the sandylona?

The National Anti-Microbial Treatment Guide (2nd Edition) shows that the sensitivity rate of the chlamydia of the sandylona is less than 30%, which is generally considered invalid, but in the "Fever-Sangford Anti-Microbio Treatment Guide (Newly Translated No. 48"Edition)" Reminder that amoxicillin is activated to the chlamydia of the trachoma, it is a alternative drug for the treatment of chlamydia infection of the sandylona.

Secondly, the literature reports that the chlamydia of the sandylona is similar to the cell wall, DNA and RNA similar to the Gram -positive bacteria, which may be the reason why the chlamydia is sensitive to Amoxicillin.

However, it should be noted that except among amoxicillin, the guide does not recommend other penicillin drugs to treat chlamydia. Therefore, when choosing a drug, it is not recommended to choose amoxicillin/Clarva.

■ The first is that the guide does not recommend amoxicillin/Claviocate to treat chlamydia infection of the sandylona, and its curative effect is not clear;

■ The second is that amoxicillin/Claviotate can increase the risk of necrosis of necrotic small intestinal colon.

In summary, the treatment of chlamydic infections in pregnant women’s reproductive tract Sandoma can be used to choose Azithromycin, erythromycin, erythromycin, and amoxicillin. When you can not apply large -ringing drugs such as AzithromycinThe righteousness rushed to the front line, exerted its veteran style, and escorted pregnant women.

Review expert: Li Chuyun, director of Huizhou Central People’s Hospital

The above is the original work of the "Drug Safety Cooperation Alliance" volunteer. If you reprint, please indicate the author and source!

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