A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. The Azithromycin for Chlamydial Infections Study Group
DH Martin, TF Mroczkowski, ZA Dalu, J McCarty, RB Jones, SJ Hopkins, and RB Johnson
BACKGROUND. Currently, there is no single-dose therapy that is effective in the treatment of urethral or endocervical infections with Chlamydia trachomatis. Azithromycin is a new azalide antibiotic that has substantial activity against C. trachomatis, is concentrated intracellularly, and has a long half-life in serum and tissue. METHODS. We conducted a trial in which 299 female patients and 158 male patients with uncomplicated genital infection and a positive C. trachomatis antigen test were randomly assigned to receive either azithromycin (1 g once orally) or doxycycline (100 mg orally twice daily for seven days). Only patients subsequently determined to have a culture positive for C. trachomatis at base line were included in the evaluation of efficacy. RESULTS. Among the patients who could be evaluated, 5 of the 141 patients (4 percent) treated with azithromycin did not respond to treatment, as compared with 3 of the 125 patients (2 percent) treated with doxycycline (difference between groups, 2 percent; 95 percent confidence interval, 0 to 6 percent). Of the patients evaluated 21 to 35 days after treatment, none of 112 treated with azithromycin and 1 of 102 treated with doxycycline had a positive culture. The rates of bacteriologic cure were similar for the 98 female patients (97 percent) and the 43 male patients (95 percent) treated with azithromycin. Seventeen percent of the patients who received azithromycin and 20 percent of those treated with doxycycline had mild-to-moderate drug-related side effects, mainly gastrointestinal symptoms. CONCLUSIONS. A single 1-g dose of azithromycin is as effective for the treatment of uncomplicated genital chlamydial infections as a standard seven-day course of doxycycline.
Source Information
Department of Medicine, Louisiana State University, New Orleans 70112.
This article has been cited by other articles:
Hahn, D. L.
(2009). Macrolide therapy in asthma: limited treatment, long-term improvement. Eur Respir J
33: 1239-1239
[Full Text]
Fung, M., Scott, K. C, Kent, C. K, Klausner, J. D
(2007). Chlamydial and gonococcal reinfection among men: a systematic review of data to evaluate the need for retesting. Sex. Transm. Infect.
83: 304-309
[Abstract][Full Text]
Riedner, G., Rusizoka, M., Todd, J., Maboko, L., Hoelscher, M., Mmbando, D., Samky, E., Lyamuya, E., Mabey, D., Grosskurth, H., Hayes, R.
(2005). Single-Dose Azithromycin versus Penicillin G Benzathine for the Treatment of Early Syphilis. NEJM
353: 1236-1244
[Abstract][Full Text]
Reveneau, N., Crane, D. D., Fischer, E., Caldwell, H. D.
(2005). Bactericidal Activity of First-Choice Antibiotics against Gamma Interferon-Induced Persistent Infection of Human Epithelial Cells by Chlamydia trachomatis. Antimicrob. Agents Chemother.
49: 1787-1793
[Abstract][Full Text]
Golden, M. R., Whittington, W. L.H., Handsfield, H. H., Hughes, J. P., Stamm, W. E., Hogben, M., Clark, A., Malinski, C., Helmers, J. R.L., Thomas, K. K., Holmes, K. K.
(2005). Effect of Expedited Treatment of Sex Partners on Recurrent or Persistent Gonorrhea or Chlamydial Infection. NEJM
352: 676-685
[Abstract][Full Text]
van Valkengoed, I. G., Morre, S. A, van den Brule, A. J., Meijer, C. J., Bouter, L. M, Boeke, A J. P
(2004). Overestimation of complication rates in evaluations of Chlamydia trachomatis screening programmes--implications for cost-effectiveness analyses. Int J Epidemiol
33: 416-425
[Abstract][Full Text]
Peipert, J. F.
(2003). Genital Chlamydial Infections. NEJM
349: 2424-2430
[Full Text]
Ostergaard, L, Andersen, B, Moller, J K, Olesen, F, Worm, A-M
(2003). Managing partners of people diagnosed with Chlamydia trachomatis: a comparison of two partner testing methods. Sex. Transm. Infect.
79: 358-361
[Abstract][Full Text]
Taylor, W. R., Richie, T. L., Fryauff, D. J., Ohrt, C., Picarima, H., Tang, D., Murphy, G. S., Widjaja, H., Braitman, D., Tjitra, E., Ganjar, A., Jones, T. R., Basri, H., Berman, J.
(2003). Tolerability of Azithromycin as Malaria Prophylaxis in Adults in Northeast Papua, Indonesia. Antimicrob. Agents Chemother.
47: 2199-2203
[Abstract][Full Text]
Ioannidis, J. P.A., Contopoulos-Ioannidis, D. G., Chew, P., Lau, J.
(2001). Meta-analysis of randomized controlled trials on the comparative efficacy and safety of azithromycin against other antibiotics for upper respiratory tract infections. J Antimicrob Chemother
48: 677-689
[Abstract][Full Text]
Dreses-Werringloer, U., Padubrin, I., Zeidler, H., Kohler, L.
(2001). Effects of Azithromycin and Rifampin on Chlamydia trachomatis Infection In Vitro. Antimicrob. Agents Chemother.
45: 3001-3008
[Abstract][Full Text]
Lenart, J., Andersen, A. A., Rockey, D. D.
(2001). Growth and Development of Tetracycline-Resistant Chlamydia suis. Antimicrob. Agents Chemother.
45: 2198-2203
[Abstract][Full Text]
(2001). Drug treatment of genital chlamydial infection. DTB
39: 27-30
[Abstract][Full Text]
Tobin, J M, Harindra, V, Tucker, L J
(2000). The future of chlamydia screening. Sex. Transm. Infect.
76: 233-234
[Full Text]
Kjar, H O, Dimcevski, G, Hoff, G, Olesen, F, Ostergaard, L
(2000). Recurrence of urogenital Chlamydia trachomatis infection evaluated by mailed samples obtained at home: 24 weeks' prospective follow up study. Sex. Transm. Infect.
76: 169-172
[Abstract][Full Text]
Widjaja, S., Cohen, S., Brady, W. E., O'reilly, K., Susanto, , Wibowo, A., Cahyono, , Graham, R. R., Porter, K. R.
(1999). Evaluation of a Rapid Assay for Detection of Chlamydia trachomatis Infections in Outpatient Clinics in South Kalimantan, Indonesia. J. Clin. Microbiol.
37: 4183-4185
[Abstract][Full Text]
Hook, E. W. III, Stephens, J., Ennis, D. M.
(1999). Azithromycin Compared with Penicillin G Benzathine for Treatment of Incubating Syphilis. ANN INTERN MED
131: 434-437
[Abstract][Full Text]
Hueston, W. J., Lenhart, J. G.
(1997). A Decision Analysis to Guide Antibiotic Selection for Chlamydia Infection During Pregnancy. Arch Fam Med
6: 551-555
[Abstract]
Barnett, E. D., Teele, D. W., Klein, J. O., Cabral, H. J., Kharasch, S. J., the Greater Boston Otitis Media Study Group,
(1997). Comparison of Ceftriaxone and Trimethoprim-Sulfamethoxazole for Acute Otitis Media. Pediatrics
99: 23-28
[Abstract][Full Text]
Stamm, W. E., Hicks, C. B., Martin, D. H., Leone, P., Hook, E. W. III, Cooper, R. H., Cohen, M. S., Batteiger, B. E., Workowski, K., McCormack, W. M., Bolan, G., Douglas, J. M. Jr, Wong, E. S., Pappas, P. G., Johnson, R. B.
(1995). Azithromycin for Empirical Treatment of the Nongonococcal Urethritis Syndrome in Men: A Randomized Double-blind Study. JAMA
274: 545-549
[Abstract]
Schmid, G. P., Fontanarosa, P. B.
(1995). Evolving Strategies for Management of the Nongonococcal Urethritis Syndrome. JAMA
274: 577-579
[Abstract]
Joshi, N., Milfred, D.
(1995). The Use and Misuse of New Antibiotics: A Perspective. Arch Intern Med
155: 569-577
[Abstract]
Braverman, P. K., Strasburger, V. C.
(1994). Sexually Transmitted Diseases. CLIN PEDIATR
33: 26-37
[Abstract]
Genc, M., Ruusuvaara, L., Mardh, P.-A.
(1993). An Economic Evaluation of Screening for Chlamydia trachomatis in Adolescent Males. JAMA
270: 2057-2064
[Abstract]
Workowski, K. A., Lampe, M. F., Wong, K. G., Watts, M. B., Stamm, W. E.
(1993). Long-term Eradication of Chlamydia trachomatis Genital Infection After Antimicrobial Therapy: Evidence Against Persistent Infection. JAMA
270: 2071-2075
[Abstract]
Workowski, K. A., Johnson, R. B., Verdon, M., Stamm, W. E.
(1993). Azithromycin in Chlamydial Urethritis. JAMA
270: 1934-1935
[Abstract]
Previous
