A 28-year-old woman in the second trimester of pregnancy is diagnosed with chlamydial cervicitis. Doxycycline is avoided. The safest effective alternative for treatment of chlamydia in pregnancy is:
- A Ciprofloxacin
- B Metronidazole
- C Clindamycin
- D Azithromycin 1g single oral dose ✓
Explanation
Doxycycline and other tetracyclines are absolutely contraindicated in pregnancy due to deposition in developing fetal bones and teeth (causing discolouration and hypoplasia) and maternal hepatotoxicity. Azithromycin 1 g orally as a single dose is the recommended safe and effective alternative for chlamydial infection in pregnancy. Ciprofloxacin is a fluoroquinolone (category C, potentially teratogenic at high doses and best avoided). Metronidazole treats bacterial vaginosis/trichomoniasis but not chlamydia. Clindamycin is active against chlamydia but is second-line.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.