Tetracyclines and fluoroquinolones are contraindicated in pregnant and lactating women. Erythromycin is clinically effective and safe for pregnant women, and, despite being less well tolerated because of gastrointestinal side effects, it remains the drug of choice for the treatment of LGV during pregnancy (erythromycin base, 500 mg orally 4 times daily for 21 days) .
Clinical experience and studies suggest that azithromycin is safe and effective for use during pregnancy. With its effectiveness against genitourinary and ocular Chlamydia organisms, azithromycin may prove to be a safe alternative to erythromycin during pregnancy. Multiple doses of azithromycin (1.0 g orally once weekly for 3 weeks) would likely be required for effective treatment.