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Mohammadzadeh F, Dolatian M, Jorjani M, Afrakhteh M, Alavi Majd H, Abdi F et al . Urogenital chlamydia trachomatis treatment failure with azithromycin: A meta-analysis
. IJRM 2019; 17 (9) :603-620
URL: http://ijrm.ir/article-1-1636-en.html
URL: http://ijrm.ir/article-1-1636-en.html
Farnaz Mohammadzadeh1 
, Mahrokh Dolatian * 2, Masoumeh Jorjani3 , Maryam Afrakhteh4 , Hamid Alavi Majd5 , Fatemeh Abdi6 , Reza Pakzad7
, Mahrokh Dolatian * 2, Masoumeh Jorjani3 , Maryam Afrakhteh4 , Hamid Alavi Majd5 , Fatemeh Abdi6 , Reza Pakzad7
1- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran , mhdolatian@gmail.com
3- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4- Department of Obstetrics and Gynaecology, Tajrish Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5- Department of Biostatistics, Paramedical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
6- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
7- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
2- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran , mhdolatian@gmail.com
3- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4- Department of Obstetrics and Gynaecology, Tajrish Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5- Department of Biostatistics, Paramedical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
6- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
7- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
Abstract: (6554 Views)
Abstract
Background: Chlamydia Trachomatis is one of the most common pathogens transmitted through the genital tract in humans that leads to urogenital infection.
Objective: Given the high prevalence of chlamydia infection and its adverse effects on the health of women and men, the present meta-analysis was conducted to determine the rate of treatment failure with azithromycin.
Materials and Methods: Databases including MEDLINE, ISI - Web of Science, PubMed, EMBASE, Scopus, ProQuest, and Science Direct were searched for articles published between 1991 and 2018. The quality of the selected articles was assessed using the Cochrane risk of bias assessment tool. Heterogeneity was determined using the I2 and Cochrane Q-Test. Subgroup analysis and meta-regression were used to compare the prevalence rates on different levels of the variables.
Results: A total of 21 articles that met the inclusion criteria were ultimately assessed. The pooled estimate of azithromycin failure rate was 11.23% (CI 95%: 8.23%-14.24%). Also, the azithromycin failure rate was 15.87% (CI 95%: 10.20%-21.54%) for the treatment of urethritis, 7.41% (CI 95%: 0.60%-14.22%) for cervicitis, and 7.14% (CI 95%: 10.90%-3.39%) for genital chlamydia. The pooled estimate of failure rate difference was 2.37% (CI 95%: 0.68%-4.06%), which shows that azithromycin has a higher failure rate in the treatment of chlamydia compared to doxycycline and other examined medications. The meta-regression results showed that the patient's age contributes significantly to the heterogeneity for azithromycin treatment failure rate (β = 0.826; p = 0.017).
Conclusion: Azithromycin has a higher failure rate than doxycycline and other studied medications in treating urogenital chlamydia infections.
Key words: Azithromycin, Chlamydia trachomatis, Urogenital, Treatment failure, Meta-analysis.
Abstract
Background: Chlamydia Trachomatis is one of the most common pathogens transmitted through the genital tract in humans that leads to urogenital infection.
Objective: Given the high prevalence of chlamydia infection and its adverse effects on the health of women and men, the present meta-analysis was conducted to determine the rate of treatment failure with azithromycin.
Materials and Methods: Databases including MEDLINE, ISI - Web of Science, PubMed, EMBASE, Scopus, ProQuest, and Science Direct were searched for articles published between 1991 and 2018. The quality of the selected articles was assessed using the Cochrane risk of bias assessment tool. Heterogeneity was determined using the I2 and Cochrane Q-Test. Subgroup analysis and meta-regression were used to compare the prevalence rates on different levels of the variables.
Results: A total of 21 articles that met the inclusion criteria were ultimately assessed. The pooled estimate of azithromycin failure rate was 11.23% (CI 95%: 8.23%-14.24%). Also, the azithromycin failure rate was 15.87% (CI 95%: 10.20%-21.54%) for the treatment of urethritis, 7.41% (CI 95%: 0.60%-14.22%) for cervicitis, and 7.14% (CI 95%: 10.90%-3.39%) for genital chlamydia. The pooled estimate of failure rate difference was 2.37% (CI 95%: 0.68%-4.06%), which shows that azithromycin has a higher failure rate in the treatment of chlamydia compared to doxycycline and other examined medications. The meta-regression results showed that the patient's age contributes significantly to the heterogeneity for azithromycin treatment failure rate (β = 0.826; p = 0.017).
Conclusion: Azithromycin has a higher failure rate than doxycycline and other studied medications in treating urogenital chlamydia infections.
Background: Chlamydia Trachomatis is one of the most common pathogens transmitted through the genital tract in humans that leads to urogenital infection.
Objective: Given the high prevalence of chlamydia infection and its adverse effects on the health of women and men, the present meta-analysis was conducted to determine the rate of treatment failure with azithromycin.
Materials and Methods: Databases including MEDLINE, ISI - Web of Science, PubMed, EMBASE, Scopus, ProQuest, and Science Direct were searched for articles published between 1991 and 2018. The quality of the selected articles was assessed using the Cochrane risk of bias assessment tool. Heterogeneity was determined using the I2 and Cochrane Q-Test. Subgroup analysis and meta-regression were used to compare the prevalence rates on different levels of the variables.
Results: A total of 21 articles that met the inclusion criteria were ultimately assessed. The pooled estimate of azithromycin failure rate was 11.23% (CI 95%: 8.23%-14.24%). Also, the azithromycin failure rate was 15.87% (CI 95%: 10.20%-21.54%) for the treatment of urethritis, 7.41% (CI 95%: 0.60%-14.22%) for cervicitis, and 7.14% (CI 95%: 10.90%-3.39%) for genital chlamydia. The pooled estimate of failure rate difference was 2.37% (CI 95%: 0.68%-4.06%), which shows that azithromycin has a higher failure rate in the treatment of chlamydia compared to doxycycline and other examined medications. The meta-regression results showed that the patient's age contributes significantly to the heterogeneity for azithromycin treatment failure rate (β = 0.826; p = 0.017).
Conclusion: Azithromycin has a higher failure rate than doxycycline and other studied medications in treating urogenital chlamydia infections.
Key words: Azithromycin, Chlamydia trachomatis, Urogenital, Treatment failure, Meta-analysis.
Abstract
Background: Chlamydia Trachomatis is one of the most common pathogens transmitted through the genital tract in humans that leads to urogenital infection.
Objective: Given the high prevalence of chlamydia infection and its adverse effects on the health of women and men, the present meta-analysis was conducted to determine the rate of treatment failure with azithromycin.
Materials and Methods: Databases including MEDLINE, ISI - Web of Science, PubMed, EMBASE, Scopus, ProQuest, and Science Direct were searched for articles published between 1991 and 2018. The quality of the selected articles was assessed using the Cochrane risk of bias assessment tool. Heterogeneity was determined using the I2 and Cochrane Q-Test. Subgroup analysis and meta-regression were used to compare the prevalence rates on different levels of the variables.
Results: A total of 21 articles that met the inclusion criteria were ultimately assessed. The pooled estimate of azithromycin failure rate was 11.23% (CI 95%: 8.23%-14.24%). Also, the azithromycin failure rate was 15.87% (CI 95%: 10.20%-21.54%) for the treatment of urethritis, 7.41% (CI 95%: 0.60%-14.22%) for cervicitis, and 7.14% (CI 95%: 10.90%-3.39%) for genital chlamydia. The pooled estimate of failure rate difference was 2.37% (CI 95%: 0.68%-4.06%), which shows that azithromycin has a higher failure rate in the treatment of chlamydia compared to doxycycline and other examined medications. The meta-regression results showed that the patient's age contributes significantly to the heterogeneity for azithromycin treatment failure rate (β = 0.826; p = 0.017).
Conclusion: Azithromycin has a higher failure rate than doxycycline and other studied medications in treating urogenital chlamydia infections.
Type of Study: Review Article |
References
1. Gwyn SE, Xiang L, Kandel RP, Dean D, Gambhir M, Martin DL. Prevalence of chlamydia trachomatis-specific antibodies before and after mass drug administration for trachoma in community-wide surveys of four communities in nepal. Am J Trop Med Hyg 2018; 98: 216-220. [DOI:10.4269/ajtmh.17-0102]
2. Zambrano AI, Sharma S, Crowley K, Dize L, Muñoz BE, Mishra SK, et al. The World Health Organization recommendations for trachoma surveillance, experience in Nepal and added benefit of testing for antibodies to Chlamydia trachomatis pgp3 protein: NESTS Study. PLoS Negl Trop Dis 2016; 10: e0005003. [DOI:10.1371/journal.pntd.0005003]
3. Upton A, Bissessor L, Lowe P, Wang X, McAuliffe G. Diagnosis of chlamydia trachomatis, neisseria gonorrhoeae, trichomonas vaginalis and mycoplasma genitalium: an observational study of testing patterns, prevalence and co-infection rates in northern new zealand. Sex Health 2018; 15: 232-237. [DOI:10.1071/SH17110]
4. Heijne M, van der Goot JA, Fijten H, van der Giessen JW, Kuijt E, Maassen CBM, et al. A cross sectional study on Dutch layer farms to investigate the prevalence and potential risk factors for different Chlamydia species. PloS One 2018; 13: e0190774. [DOI:10.1371/journal.pone.0190774]
5. Tamarelle J, Thiébaut ACM, de Barbeyrac B, Bébéar C, Ravel J, Delarocque-Astagneau E. The vaginal microbiota and its association with Human Papillomavirus, Chlamydia trachomatis, Neisseria gonorrhea and Mycoplasma genitalium infections: a systematic review and meta-analysis. Clin Microbiol Infect 2019; 25: 35-47. [DOI:10.1016/j.cmi.2018.04.019]
6. Giffard PM, Lilliebridge RA, Wilson J, Murray G, Phillips S, Tabrizi SN, et al. Contaminated fingers: a potential cause of Chlamydia trachomatis-positive urine specimens. Sex Transm Infect 2018; 94: 32-36. [DOI:10.1136/sextrans-2016-053081]
7. Schuchardt L, Rupp J. Chlamydia trachomatis as the cause of infectious infertility: acute, repetitive or persistent long-term infection? Biology of Chelamydia 2016; 159-182. [DOI:10.1007/82_2016_15]
8. Reekie J, Donovan B, Guy R, Hocking JS, Kaldor JM, Mak DB, et al. Risk of pelvic inflammatory disease in relation to chlamydia and gonorrhea testing, repeat testing, and positivity: a population-based cohort study. Clin Infect Dis 2017; 66: 437-443. [DOI:10.1093/cid/cix769]
9. Olson KM, Tang J, Brown L, Press CG, Geisler WM. HLA-DQB1* 06 is a risk marker for chlamydia reinfection in African American women. Genes Immun 2019; 20: 69-73. [DOI:10.1038/s41435-018-0014-3]
10. Lohi KM, Kumar CA, Fonseca MN, Baveja SM, Panchal SS. Study of Chlamydia trachomatis Infection in Infertile Females at a Tertiary Care Hospital in Mumbai, India. Int J Curr Microbiol App Sci 2018; 7: 1985-2000. [DOI:10.20546/ijcmas.2018.703.234]
11. WHO. WHO guidelines for the treatment of Chlamydia trachomatis. World Health Organization: Switzerland; 2016.
12. Unemo M, Salado-Rasmussen K, Hansen M, Olsen AO, Falk M, Golparian D, et al. Clinical and analytical evaluation of the new Aptima Mycoplasma genitalium assay, with data on M. genitalium prevalence and antimicrobial resistance in M. genitalium in Denmark, Norway and Sweden in 2016. Clin Microbiol Infect 2018; 24: 533-539. [DOI:10.1016/j.cmi.2017.09.006]
13. Taylor BD, Zheng X, O'Connell CM, Wiesenfeld HC, Hillier SL, Darville T. Risk factors for Mycoplasma genitalium endometritis and incident infection: a secondary data analysis of the T cell Response Against Chlamydia (TRAC) Study. Sex Transm Infect 2018; 94: 414-420. [DOI:10.1136/sextrans-2017-053376]
14. Panos G. Prevalence studies of M. genitalium and other sexually transmitted pathogens in high risk individuals indicate the need for comprehensive investigation of STIs for accurate diagnosis and effective treatment. Germs 2018; 8: 8-11. [DOI:10.18683/germs.2018.1127]
15. Couldwell DL, Lewis DA. Mycoplasma genitalium infection: current treatment options, therapeutic failure, and resistance-associated mutations. Infect Drug Resist 2015; 8: 147-161. [DOI:10.2147/IDR.S48813]
16. Horner P, Ingle SM, Garrett F, Blee K, Kong F, Muir P, et al. Which azithromycin regimen should be used for treating Mycoplasma genitalium? A meta-analysis. Sex Transm Infect 2018; 94: 14-20. [DOI:10.1136/sextrans-2016-053060]
17. Bradshaw CS, Horner PJ, Jensen JS, White PJ. Syndromic management of STIs and the threat of untreatable Mycoplasma genitalium. Lancet Infect Dis 2018; 18: 251-252. [DOI:10.1016/S1473-3099(18)30080-X]
18. Rothman A, Jean R. Macrolide-Resistant Mycoplasma: An Increasing Problem. In: B52. Bacterial Infection Case Reports: American Thoracic Society; 2018: A3593.
19. Lee H, Yun KW, Lee HJ, Choi EH. Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. Expert Rev Anti Infect Ther 2018; 16: 23-34. [DOI:10.1080/14787210.2018.1414599]
20. Abdi F, Mobedi H, Bayat F, Mosaffa N, Dolatian M, Ramezani Tehrani F. The effects of transdermal estrogen delivery on bone mineral density in postmenopausal women: a meta-analysis. Iran J Pharm Res 2017; 16: 380-389.
21. Abdi F, Alimoradi Z, Haqi P, Mahdizad F. Effects of phytoestrogens on bone mineral density during the menopause transition: a systematic review of randomized, controlled trials. Climacteric 2016; 19: 535-545. [DOI:10.1080/13697137.2016.1238451]
22. Geisler WM, Uniyal A, Lee JY, Lensing SY, Johnson S, Perry RC, et al. Azithromycin versus doxycycline for urogenital Chlamydia trachomatis infection. N Engl J Med 2015; 373: 2512-2521. [DOI:10.1056/NEJMoa1502599]
23. Geisler WM, Pascual MLG, Mathew J, Koltun WD, Morgan F, Batteiger BE, et al. Randomized, double-blind, multi-center safety and efficacy study of rifalazil compared with azithromycin for the treatment of uncomplicated genital Chlamydia trachomatis infection in women. Antimicrobial Agents and Chemotherapy 2014; 58: 4014-4019. [DOI:10.1128/AAC.02521-14]
24. Beyda RM, Benjamins LJ, Symanski E, Swartz M, Risser WL, Eissa M. Azithromycin efficacy in the treatment of Chlamydia trachomatis among detained youth. Sex Transm Dis 2014; 41: 592-594. [DOI:10.1097/OLQ.0000000000000180]
25. Takahashi S, Kiyota H, Ito S, Iwasawa A, Hiyama Y, Uehara T, et al. Clinical efficacy of a single two gram dose of azithromycin extended release for male patients with urethritis. Antibiotics 2014; 3: 109-120. [DOI:10.3390/antibiotics3020109]
26. Manhart LE, Gillespie CW, Lowens MS, Khosropour CM, Colombara DV, Golden MR, et al. Standard treatment regimens for nongonococcal urethritis have similar but declining cure rates: a randomized controlled trial. Clin Infect Dis 2013; 56: 934-942. [DOI:10.1093/cid/cis1022]
27. Schwebke JR, Rompalo A, Taylor S, Sena AC, Martin DH, Lopez LM, et al. Re-evaluating the treatment of nongonococcal urethritis: emphasizing emerging pathogens-a randomized clinical trial. Clin Infect Dis 2011; 52: 163-170. [DOI:10.1093/cid/ciq074]
28. Schillinger JA, Kissinger P, Calvet H, Whittington WL, Ransom RL, Sternberg MR, et al. Patient-delivered partner treatment with azithromycin to prevent repeated Chlamydia trachomatis infection among women: a randomized, controlled trial. Sex Transm Dis 2003; 30: 49-56. [DOI:10.1097/00007435-200301000-00011]
29. Jang D, Sellors J, Howard M, Mahony J, Frost E, Patrick D, et al. Correlation between culture testing of swabs and ligase chain reaction of first void urine from patients recently treated for Chlamydia trachomatis. Sex Transm Infect 2003; 79: 237-239. [DOI:10.1136/sti.79.3.237]
30. Rustomjee R, Kharsany AB, Connolly CA, Karim SS. A randomized controlled trial of azithromycin versus doxycycline/ciprofloxacin for the syndromic management of sexually transmitted infections in a resource-poor setting. J Antimicrob Chemother 2002; 49: 875-878. [DOI:10.1093/jac/dkf034]
31. Škerk V, Schönwald S, Strapač Z, Beus A, Francetić I, Krhen I, et al. Duration of clinical symptoms in female patients with acute urethral syndrome caused by Chlamydia trachomatis treated with azithromycin or doxycycline. J Chemother 2001; 13: 176-181. [DOI:10.1179/joc.2001.13.2.176]
32. Kacmar J, Cheh E, Montagno A, Peipert JF. A randomized trial of azithromycin versus amoxicillin for the treatment of Chlamydia trachomatis in pregnancy. Infect Dis Obstet Gynecol 2001; 9: 197-202. [DOI:10.1155/S1064744901000321]
33. Sendaǧ F, Terek C, Tuncay G, özkinay E, Güven M. Single dose oral azithromycin versus seven day doxycycline in the treatment of non‐gonococcal mucopurulent endocervicitis. Aust N Z J Obstet Gynaecol 2000; 40: 44-47. [DOI:10.1111/j.1479-828X.2000.tb03165.x]
34. Hillis SD, Coles FB, Litchfield B, Black CM, Mojica B, Schmitt K, et al. Doxycycline and azithromycin for prevention of chlamydial persistence or recurrence one month after treatment in women: a use-effectiveness study in public health settings. Sex Transm Dis 1998; 25: 5-11. [DOI:10.1097/00007435-199801000-00002]
35. Thorpe EM Jr, Stamm WE, Hook EW, Gall SA, Jones RB, Henry K, et al. Chlamydial cervicitis and urethritis: single dose treatment compared with doxycycline for seven days in community based practises. Genitourin Med 1996; 72: 93-97. [DOI:10.1136/sti.72.2.93]
36. Brihmer C, Mardh PA, Kallings I, Osser S, Robech M, Sikstrom B, et al. Efficacy and safety of azithromycin versus lymecyline in the treatment of genital chlamydial infections in women. Scand J Infect Dis 1996; 28: 451-454. [DOI:10.3109/00365549609037938]
37. Stamm WE, Hicks CB, Martin DH, Leone P, Hook EW, Cooper RH, et al. Azithromycin for empirical treatment of the nongonococcal urethritis syndrome in men: a randomized double-blind study. JAMA 1995; 274: 545-549. [DOI:10.1001/jama.1995.03530070043027]
38. Hammerschlag MR, Golden NH, Oh MK, Gelling M, Sturdevant M, Brown PR, et al. Single dose of azithromycin for the treatment of genital chlamydial infections in adolescents. J Pediatr 1993; 122: 961-965. [DOI:10.1016/S0022-3476(09)90029-4]
39. Lauharanta J, Saarinen K, Mustonen MT, Happonen HP. Single-dose oral azithromycin versus seven-day doxycycline in the treatment of non-gonococcal urethritis in males. J Antimicrob Chemother 1993; 31 (suppl.): 177-183. [DOI:10.1093/jac/31.suppl_E.177]
40. Martin DH, Mroczkowski TF, Dalu ZA, McCarty J, Jones RB, Hopkins SJ, et al. A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. The azithromycin for chlamydial infections study group. N Engl J Med 1992; 327: 921-925. [DOI:10.1056/NEJM199209243271304]
41. Nilsen A, Halsos A, Johansen A, Hansen E, Tørud E, Moseng D, et al. A double blind study of single dose azithromycin and doxycycline in the treatment of chlamydial urethritis in males. Genitourin Med 1992; 68: 325-327. [DOI:10.1136/sti.68.5.325]
42. Whatley JD, Thin RN, Mumtaz G, Ridgway GL. Azithromycin vs doxycycline in the treatment of non-gonococcal urethritis. Int J STD AIDS 1991; 2: 248-251. [DOI:10.1177/095646249100200404]
43. Kissinger PJ, White S, Manhart LE, Schwebke J, Taylor SN, Mena L, et al. Azithromycin treatment failure for Chlamydia trachomatis among heterosexual men with nongonococcal urethritis. Sex Transm Dis 2016; 43: 599-602. [DOI:10.1097/OLQ.0000000000000489]
44. Kong FY, Tabrizi SN, Fairley CK, Vodstrcil LA, Huston WM, Chen M, et al. The efficacy of azithromycin and doxycycline for the treatment of rectal chlamydia infection: a systematic review and meta-analysis. J Antimicrob Chemother 2015; 70: 1290-1297. [DOI:10.1093/jac/dku574]
45. Kong FY, Tabrizi SN, Fairley CK, Phillips S, Fehler G, Law M, et al. Higher organism load associated with failure of azithromycin to treat rectal chlamydia. Epidemiol Infect 2016; 144: 2587-2596. [DOI:10.1017/S0950268816000996]
46. Kong FY, Tabrizi SN, Law M, Vodstrcil LA, Chen M, Fairley CK, et al. Azithromycin versus doxycycline for the treatment of genital chlamydia infection: a meta-analysis of randomized controlled trials. Clin Infect Dis 2014; 59: 193-205. [DOI:10.1093/cid/ciu220]
47. Ljubin-Sternak S, Mestrovic T, Vilibic-Cavlek T, Mlinaric-Galinovic G, Sviben M, Markotic A, et al. In vitro susceptibility of urogenital Chlamydia trachomatis strains in a country with high azithromycin consumption rate. Folia Microbiol 2013; 58: 361-365. [DOI:10.1007/s12223-012-0218-2]
48. Bhengraj AR, Vardhan H, Srivastava P, Salhan S, Mittal A. Decreased susceptibility to azithromycin and doxycycline in clinical isolates of Chlamydia trachomatis obtained from recurrently infected female patients in India. Chemotherapy 2010; 56: 371-377. [DOI:10.1159/000314998]
49. Deguchi T, Hatazaki K, Ito S, Kondo H, Horie K, Nakane K, et al. Macrolide and fluoroquinolone resistance is uncommon in clinical strains of Chlamydia trachomatis. J Infect Chemother 2018; 24: 610-614. [DOI:10.1016/j.jiac.2018.03.007]
50. Lawrence A, Hocking JS, Wee B, Vodstrcil L, Timms P, Tabrizi S, et al. Distinct growth and genome profiles are present in clinical isolates from women who fail to resolve genital chlamydia infection after azithromycin treatment. Sex Transm Infect 2015; 91 (Suppl.): A1-A37. [DOI:10.1136/sextrans-2015-052270.108]
51. Yeruva L, Melnyk S, Spencer N, Bowlin A, Rank RG. Differential susceptibility to azithromycin treatment of chlamydial infection in the gastrointestinal tract and cervix. Antimicrob Agents Chemother 2013: 57: 6290-6294. [DOI:10.1128/AAC.01405-13]
52. Ossewaarde JM, Plantema FH, Rieffe M, Nawrocki RP, De Vries A, Van Loon AM. Efficacy of single-dose azithromycin versus doxycycline in the treatment of cervical infections caused byChlamydia trachomatis. Eur J Clin Microbiol Infect Dis 1992; 11: 693-697. [DOI:10.1007/BF01989972]
53. Quinn TC, Gaydos CA. Treatment for chlamydia infection-doxycycline versus azithromycin. Mass Medical Soc 2015: 2573-2575. [DOI:10.1056/NEJMe1513001]
54. Dukers-Muijrers NH, Speksnijder AG, Morré SA, Wolffs PF, van der Sande MA, Brink AA, et al. Detection of anorectal and cervicovaginal Chlamydia trachomatis infections following azithromycin treatment: prospective cohort study with multiple time-sequential measures of rRNA, DNA, quantitative load and symptoms. PloS One 2013; 8: e81236. [DOI:10.1371/journal.pone.0081236]
55. Tan HH, Chan RK. An open label comparative study of azithromycin and doxycycline in the treatment of non-gonococcal urethritis in males and Chlamydia trachomatis cervicitis in female sex workers in an STD clinic in Singapore. Singapore Med J 1999; 40: 519-523.
56. Steingrimsson O, Olafsson JH, Thorarinsson H, Ryan RW, Johnson RB, Tilton RC. Azithromycin in the treatment of sexually transmitted disease. J Antimicrob Chemother 1990; 25 (Suppl.): 109-114. [DOI:10.1093/jac/25.suppl_A.109]
57. Bernstein KT, Marcus JL, Nieri G, Philip SS, Klausner JD. Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion. J Acquir Immune Defic Syndr 2010; 53: 537-543. [DOI:10.1097/QAI.0b013e3181c3ef29]
58. Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64: 1-137.
59. Michel CE, Sonnex C, Carne CA, White JA, Magbanua JP, Nadala ECJr, et al. Chlamydia trachomatis load at matched anatomic sites: implications for screening strategies. J Clin Microbiol 2007; 45: 1395-1402. [DOI:10.1128/JCM.00100-07]
60. Geisler WM, Suchland RJ, Whittington WL, Stamm WE. Quantitative culture of Chlamydia trachomatis: relationship of inclusion-forming units produced in culture to clinical manifestations and acute inflammation in urogenital disease. J Infect Dis 2001; 184: 1350-1354. [DOI:10.1086/323998]
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