AZITHROMYCIN’S ROLE IN PREVENTING ABORTIONS IN TOXOPLASMOSIS-POSITIVE PREGNANT WOMEN AT FAMILY HEALTH HOSPITAL, KOHAT

Abstract

Aim: To assess the effectiveness of azithromycin in preventing spontaneous abortion among pregnant women diagnosed with toxoplasmosis.

Methodology :This prospective observational study was conducted at the Department of Pharmacology, Islam Medical College Sialkot, Pakistan in the duration from September, 2023 to May, 2024, involving 88 pregnant women aged 18-40 years diagnosed with toxoplasmosis through serological testing. Participants, between 8 and 20 weeks of gestation, were divided into two treatment groups: Group A (Azithromycin) and Group B (Clindamycin). Exclusion criteria included a history of drug reactions to either medication and unwillingness to participate. Group A received oral Azithromycin (500 mg daily for three days, followed by 250 mg daily for four weeks), while Group B received oral Clindamycin (300 mg every six hours for four weeks). The primary outcome was spontaneous abortion before 20 weeks, and secondary outcomes included preterm birth, stillbirth, and congenital toxoplasmosis. Baseline demographic information and follow-ups every four weeks until delivery were recorded. Data were analyzed using SPSS version 22.0, with means, standard deviations, frequencies, and percentages calculated. Fisher’s exact test compared treatment outcomes. The study was ethically approved, and informed consent was obtained from all participants.

Results: This study involved 88 pregnant women aged between 18-40 years with toxoplasmosis, divided into Group A (Azithromycin) and Group B (Clindamycin), each with 44 participants. The study evaluated primary outcomes of spontaneous abortion and secondary outcomes of preterm birth, stillbirth, and congenital toxoplasmosis. Participants were evenly distributed across age groups, with comparable health conditions, residential areas, socioeconomic statuses, and BMI categories between groups. Group A had a lower spontaneous abortion rate (4.55%) compared to Group B (9.09%), although the difference was not statistically significant (p=1.000). Secondary outcomes also showed no significant differences. Despite the lack of statistical significance, the lower abortion rate in the Azithromycin group suggests a potential benefit, warranting further investigation.

Conclusion: The study's findings point to the possibility of using azithromycin rather than clindamycin to treat toxoplasmosis in pregnancy, as evidenced by the lower likelihood of spontaneous abortion in azithromycin treated group. Despite the lack of statistical significance, these results suggest that azithromycin could be an effective alternative.