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SINGLE-DOSE AZITHROMYCIN ERADICATES PELVIC CHLAMYDIAL INFECTIONS.

Urogenital chlamydial infection is the most common sexually transmitted disease in the U.S. The conventional 7-day course of doxycycline is effective therapy, but compliance is suboptimal, particularly in asymptomatic patients. The antibiotic azithromycin, recently approved by the FDA, has excellent in vitro activity against chlamydia (and other pelvic pathogens), and a single dose produces sustained high tissue levels. This multicenter study evaluated single-dose azithromycin in 266 male and female patients with a positive Chlamydia trachomatis antigen test.

Patients randomly received either a single dose of oral azithromycin (1 g) or a 7-day regimen of doxycycline (100 mg twice daily). Culture cure rates were 96 percent with azithromycin and 98 percent with doxycycline. Three weeks after treatment, 100 percent of patients given azithromycin and 99 percent of those given doxycycline were asymptomatic. Bacteriologic cure rates were similar in men and women. Mild to moderate side effects, usually gastrointestinal, occurred in 17 percent of the azithromycin group and 20 percent of the doxycycline group; only one patient given doxycycline withdrew because of such symptoms.

This study firmly establishes that a single dose of azithromycin is the treatment of choice for urogenital chlamydial infections. Whether azithromycin is effective for treating gonococcal and ureaplasmal infections remains to be established.

— ALK

Published in Journal Watch General Medicine October 2, 1992

Citation(s):

Martin DH et al. A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. N Engl J Med 1992 Sep 24 327 921-925.

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