Clinical recommendation	Evidence rating	References	Comments
Azithromycin (Zithromax) is an effective treatment for chlamydia during pregnancy.	B	5	No long-term safety studies have been performed.
Intramuscular ceftriaxone (Rocephin) and oral cefixime (Suprax) are similar in effectiveness for gonorrhea during pregnancy.	B	6, 8	Spectinomycin (Trobicin; not available in the United States) is also effective but is painful to use.
Initiation of acyclovir (Zovirax) or valacyclovir (Valtrex) treatment at 36 weeks' gestation reduces the recurrence of genital herpes lesions and the number of cesarian deliveries performed because of genital herpes.	A	10, 11	In patients with known herpes. Serologic screening is not advocated.
Penicillin is effective in the prevention of congenital syphilis.	A	20	Needs to be found and treated early. Screening should be carried out at the first visit.
Treatment of trichomoniasis does not reduce the incidence of preterm birth.	A	21	Screening in asymptomatic women is not recommended.