Management strategy for pregnant women with pelvic inflammatory disease and chronic chlamydia infection: the role of josamycin in the case of the replicated drug Jozaphen

Objective. To substantiate the optimal therapeutic strategy for pregnant women with chronic chlamydia infection, focusing on the effectiveness and safety of josamycin in a clinical example of the use of the generic drug Jozaphen. Materials and methods. An analysis of modern international and domestic clinical guidelines, data from randomized controlled studies, systematic reviews, and meta-analyses on the treatment of urogenital chlamydia and pelvic inflammatory disease, including in pregnant women, was conducted. Special attention was paid to the pharmacological properties, safety profile, and effectiveness of macrolides, particularly josamycin. Results. It has been established that PID caused by both absolute pathogens and opportunistic pathogens is associated with a high risk of reproductive and obstetric complications. The management of this category of patients requires a comprehensive approach that includes etiotropic therapy that is allowed during gestation. As a 16-membered macrolide, josamycin demonstrates high clinical and microbiological efficacy against Chlamydia trachomatis, has a favorable safety profile for the fetus and the pregnant woman, and is recommended as a first-line drug for the treatment of chlamydia in pregnant women. Conclusion. The use of josamycin as part of the complex therapy for pregnant women with pelvic inflammatory disease and chronic chlamydia infection appears to be an etiologically sound and clinically effective strategy. It allows not only to eradicate the pathogen, but also to stop the chronic inflammatory process in the pelvic organs, thereby reducing the risk of developing severe obstetric and perinatal complications.