Antibiotics for gonorrhoea in pregnancy

Brocklehurst P

Published Online:

October 7, 2009

Pregnant women with gonorrhoea who take penicillin, spectinomycin or ceftriaxone are much less likely to show signs of infection.

Neisseria gonorrhoeae is a bacteria transmitted (passed) during sex, causing an infection in the genital area. Pregnant women with gonorrhoea may pass the infection to babies during birth. This can affect the baby's eyesight, causing blindness. The review of trials found evidence that pregnant women who take penicillin, spectinomycin, ceftriaxone or cefixime are much less likely to have signs of gonorrhoea a week to 10 days later. Further research is needed to find out which antibiotic treatment is the best for preventing infection of the baby.

Abstract (click to read)

Background:

Neisseria gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth and can cause gonococcal ophthalmia neonatorum as well as systemic neonatal infection. It can also cause endometritis and pelvic sepsis in the mother.

Objectives:

The objective of this review was to assess the effects of antibiotic regimens in the treatment of genital infection with gonorrhoea during pregnancy with respect to neonatal and maternal morbidity.

Search strategy:

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2009).

Selection criteria:

Randomized trials of one regimen of antibiotic versus another in pregnant women with culture confirmed genital gonococcal infection.

Data collection and analysis:

Eligibility and trial quality were assessed by one review author.

Main results:

Two trials involving 346 women were included. The only outcome included in these trials was the incidence of 'cure' assessed by bacterial culture. Failure to achieve 'microbiological cure' was similar for each antibiotic regimen: amoxicillin plus probenecid compared with spectinomycin (Peto odds ratio (Peto OR) 2.29, 95% confidence interval (CI) 0.74 to 7.08), amoxicillin plus probenecid compared with ceftriaxone (Peto OR 2.29, 95% CI 0.74 to 7.08) and ceftriaxone compared with cefixime (Peto OR 1.22, 95% CI 0.16 to 9.01). Side-effects were uncommon for all the tested regimens.

Authors' conclusions:

The number of women included in each of the comparisons is small and therefore, although no differences were detected between the different antibiotic regimens, the trials were limited in their ability to detect important but modest differences. For women who are allergic to penicillin, this review provides some reassurance that treatment with ceftriaxone or spectinomycin appears to have similar effectiveness in producing microbiological cure.

This record should be cited as:

Brocklehurst P. Antibiotics for gonorrhoea in pregnancy. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD000098. DOI: 10.1002/14651858.CD000098

Assessed as up to date:

June 12, 2009

Find the research

Get full text at The Cochrane Library

Primary Review Group:

Pregnancy and Childbirth Group

Health topics:

Gynaecology > Sexually transmitted disease > Gonorrhoea

Infectious disease > Sexually transmitted disease > Gonorrhoea

Pregnancy & childbirth > Infection during pregnancy > Sexually transmitted diseases

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Independent high-quality evidence for health care decision making

Antibiotics for gonorrhoea in pregnancy

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