REVIEW JOURNAL

AZITHROMYCIN VERSUS DOXYCYCLINE FOR

UROGENITAL CHLAMYDIA TRACHOMATIS INFECTION
 BACKGROUND
The most prevalent
Urogenital Chlamydia
v bacterial sexually
trachomatis
transmitted infection
Effort preventation and control
chlamydia trachomatis  Failed to reduce
In female  PID  reduction sequele prevalence
Ecttopic pregnancy
and infertility
Result of screening  effective
treatment is effective for CDC recommends 
control prevalence chlamdydia Azithromycin in a single
dose or 100 mg of
doxycyline twicw daily for 7
days
 Why doxycyline and From metanalysis
azithromycin ??

Efficacy Efficacy doxycycline

azithromycin agains agains chlamydia 
chlamydia  97% 98%

Had limitation

Used test were less

senstive and no Reinfection from Theres no repeted test 2-5
recommended partner not be weeks after treatment
controlled

Adherence to Positive test post therapy Diffocult to determine

doxycycline not ensured difficult determine  relpas from incomplete
treatment failure or eradication
Lead to treatmet failure reinfection

other study
In two othe study
azithromycin vs rifalazil 
azithromycin efficacy 92%
Two addres the ilmitation
of previous studies
Three study of nogonococcal
urethritis  showed
azithromycin efficacy <90% in
male
We choose youth correctional facilities,
1. because chlamydia infection high in this population
2. residents of youth correctional facilities are usually not reexposed to
untreated partners,
3. treatment is directly observed
4. Screening constant all partners from minimalize infection from ne partener
We obtained a sexual history
per- formed outer membrane protein A (OmpA) geno- typing on C.
trachomatis strains to more accurately classify treatment outcomes.
 METHODS

STUDY DESIGN AND

PARTICIPANS
Inclusion criteria :
Male and female 12 – 21 y.o who were residing in four long-term, sex- segregated youth correctional facilities in
Los Angeles.
Positive screening nucleic acid amplification test result and,
after obtaining written informed consen

The study begin from December 2009

Nucleic acid amplification testing to screen for chlamydia (APTIMA Combo 2, Gen-Probe) is routinely performed
Routine gential examination within 96 hours after intake
The exclusion criteria a.
a. pregnancy,
b. breast- feeding,
c. gonorrhea coinfection,
d. allergy to tetra- cyclines or b.
macrolides,
e. previous photosensitivity from
doxycycline,
f. an inability to swallow pills, c.
receipt of an antibiotic with
antichlamydial ac- tivity within
21 days before screening or be-
tween screening and enrollment
concomitant infection requiring
treatment with an antibiotic
agent that had antichlamydial
activity,
PID or epididymitis
STUDY
OVERSIGHT
The study was approved by the institutional re- view board at the
University of Alabama at Bir- mingham and at the County of Los
Angeles Public Health Department

Data were collected by LA County study staff, managed by FHI

360 and analyzed by statisticians from the University of Arkansas
for Medical Sciences