Doxycycline More Effective Than Azithromycin For Chlamydia
Trial finds doxycycline slightly more effective, but researchers not entirely convinced of its superiority.
Clinical research
National Cancer Institute / Science Photo Library
Standard treatment for chlamydia is a single dose of azithromycin or a weeks course of doxycycline twice daily. However, evidence suggests that azithromycin may not be as effective as doxycycline.
To establish efficacy, US researchers randomly assigned adolescents with urogenital Chlamydia trachomatis infection to azithromycin or doxycycline . The participants were residents at youth correctional facilities, which made the chances of reinfection low, say the researchers.
The efficacy of doxycycline was 100%, compared with 97% for azithromycin. The results meant that azithromycin was not deemed as clinically effective as doxycycline.
However, writing in TheNew England Journal of Medicine , the researchers say that the exceptional efficacy of doxycycline may be offset by poorer adherence to the week-long regimen in real-world settings.
Parents Have A Role In Chlamydia Prevention
Parents can do two main things to help their kids avoid getting chlamydia and other sexually transmitted infections , says Dombrowski. These two things are:
How Is Chlamydia Diagnosed
Unfortunately, symptoms of chlamydia rarely occur and that means you can live undiagnosed for a long time. If you have had unprotected sex of any kind, you can be at risk for chlamydia. There isnt a way to guarantee you will be safe from chlamydia, however you can reduce your chance of infection if you are properly using a condom during sex.
Its important to know that chlamydia doesnt only occur in the cervix or urethra. Eye infections, epididymitis, and throat infections can occur as well. Chlamydia isnt spread through any one sexual activity, oral sex and anal sex can also lead to chlamydial infection. Reinfection is also possible so it is important to participate in regular sexually transmitted diseases screenings, especially if you are engaging in high-risk sexual activity such as unprotected sex.
Symptoms of chlamydia can include abnormal vaginal discharge, burning when urinating, pain or swelling of the testicles, and rectal pain. If you suspect you may have contracted chlamydia or if you are showing symptoms of chlamydia you should contact your primary care doctor, urologist, or OBGYN immediately for testing. Your doctor will likely swab the urethra or cervix for lab analysis. They may also request a urine sample that they will test for both chlamydia and gonorrhea.
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Getting A Medical Diagnosis
Antibiotics For Chlamydia: Treatment
Antibiotics work very well to treat infections like Chlamydia and Gonorrhea. Unlike gonorrhea bacterium which is intra-cellular the Chlamydia bacterium is inter-cellular and live within the cell of the host. So the antibiotics have to kill the bacterium rather than merely destroy its cell walls. Some antibiotics do it with great potency and the infection is generally cured within 10 days.
Chlamydia Antibiotics like Doxycycline and Azithromycin are the preferred antibiotics. They have a very high cure rate of only a week in up to 98% of cases. Few cases might take longer to cure. It is also advised to complete the course of antibiotics even after the disease is cured within a week so as to eliminate any residual strains.
Penicillin was a very popular antibiotic used to treat STD-like Gonorrhea and Chlamydia. Over the years though the Chlamydia and Gonorrhea bacterium have mutated to exhibit resistance and immunity to penicillin. Due to that it is no longer the preferred antibiotic to treat chlamydia. Other medications like ofloxacin, erithromycin and Levofloxacin can be used but they carry increased risk of side effects. Moreover their cure rates are not as good as azithromycin and doxycycline.
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Antibiotics For Treating Genital Chlamydia Trachomatis Infection In Men And Non
Review question
This systematic review assessed the effectiveness and safety of antibiotic treatment for Chlamydia trachomatis genital infection in terms of microbiological or clinical failure in men and non-pregnant women.
Background
CT is the most frequent cause of urinary tract and genital infections in women and men. However, women frequently show no symptoms when they are infected. CT infection can lead to complications or cause further problems in reproductive health in women , and men , or chronic pelvic pain. Clinical guidelines for treating CT do not recommend a preferred antibiotic treatment. This Cochrane review evaluates all randomised controlled studies , that included antibiotics for the treatment of genital CT infection that are recommended by the most up-to-date clinical guidelines.
Search date
We searched for studies published up to June 2018 that provided information about failure to eliminate the CT infection or improve the symptoms, presence of adverse events, antimicrobial resistance, and reinfection. as treatment outcomes
Study characteristics
Study funding sources
One study reported funding from academic grants, another four studies declared having received sponsorship or grants from pharmaceutical companies. The other studies declared that they were self-funded or did not mention funding at all.
Key results
Quality of evidence
To assess the efficacy and safety of antibiotic treatment for CT genital infection in men and non-pregnant women.
What You Need To Know About Azithromycin For Chlamydia Treatment
Chlamydia is one of the most common sexually transmitted diseases in America.
In fact, in 2018, four million infections occurred in the U.S. However, many cases may go unreported because people with chlamydia are often asymptomatic and therefore dont know they have an infection.
Because chlamydia can go undetected, regular testing is extremely important in both fighting the spread of the infection and in treating it.
If you happen to test positive, the good news is, the vast majority of chlamydia cases can be cured easily with antibiotics such as azithromycin.
In this article, Ill explain if azithromycin treats chlamydia, who can take this antibiotic, the best dosage to treat chlamydia, and how to take it.
Then Ill break down how azithromycin compares with another antibiotic, doxycycline, for treating chlamydia.
Finally, Ill share everything you need to know about being tested for chlamydia.
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What Dosage Treats Chlamydia
For people with uncomplicated genital chlamydia, the Centers for Disease Control and Prevention recommends a single dose of azithromycin taken orally to cure the infection.
Azithromycin comes in three forms:
- Tablet
- Regular-release powder
For both powder formulas, either you or a pharmacist mix it with liquid to take.
Always follow the directions from your doctor or pharmacist for taking azithromycin.
Azithromycin is taken as a single dose, one time.
It should be taken as soon as you receive the prescription. Azithromycin can be taken with or without food, however, the extended-release form is typically taken on an empty stomach.
If you take the liquid form, shake it well before using and use a dosing spoon to measure an accurate dose. If you are prescribed the powder, mix it with water according to directions.
Granuloma Inguinale And Lymphogranuloma Venereum
Granuloma inguinale and lymphogranuloma venereum are rare in the United States. Granuloma inguinale presents as a painless, highly vascular ulcer that is caused by Calymmatobacterium granulomatis. Patients with lymphogranuloma venereum present most often with regional lymphadenopathy it is often a diagnosis of exclusion. The disease is caused by L serogroup strains of Chlamydia trachomatis. The diagnosis is usually made clinically and serologically. Treatment regimens for these diseases are given in Table 1.
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Detection Of Genitourinary And Extragenital C Trachomatis And N Gonorrhoeae Infections In Cases Of Sexual Assault
Detailed information about evaluation and treatment of suspected victims of sexual assault can be obtained from the 2010 STD treatment guidelines . General recommendations pertaining only to C. trachomatis and N. gonorrhoeae testing are presented here. Examination of victims is required for two purposes: 1) to determine if an infection is present so that it can be successfully treated and 2) to acquire evidence for potential use in a legal investigation. Testing to satisfy the first purpose requires a method that is highly sensitive, whereas satisfying the second purpose requires a method that is highly specific. Although NAATs meet these criteria, acceptance of any test results is determined by local legal authorities. Local legal requirements and guidance also should be sought for maintaining and documenting a chain of custody for specimens and results that might be used in a legal investigation and for which test results are accepted as evidence.
Treating Other Types Of Chlamydial Infections
Two other conditions caused by Chlamydia trachomatis are uncommon in the United States, but very common worldwide:
- Lymphogranuloma venereum : Lymphogranuloma venereum is treated in the same way as standard genital chlamydia infections, but a longer course of therapy is used . Other care may also be required to treat genital ulcers or abscessed inguinal nodes if they occur.
- Trachoma: Trachoma is the leading preventable cause of blindness worldwide and often requires aggressive treatment with antibiotics and surgery addressing unsanitary living conditions is also necessary.
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Management Of Sex Partners
Sex partners should be referred for evaluation, testing, and presumptive treatment if they had sexual contact with the partner during the 60 days preceding the patients onset of symptoms or chlamydia diagnosis. Although the exposure intervals defining identification of sex partners at risk are based on limited data, the most recent sex partner should be evaluated and treated, even if the time of the last sexual contact was > 60 days before symptom onset or diagnosis.
What Is Antibiotic Resistance And How Does It Develop
Antibiotics have been widely used to fight infections, including sexually transmitted diseases like gonorrhea, for more than 75 years. However, the bacteria that cause STDs have fought back. Over time, they have adapted so that a growing number of antibiotics can no longer treat them.
Each year, according to the CDC, at least 2 million people in the U.S. pick up these difficult-to-treat infections, which include a growing number of gonorrhea cases that are resistant to antibiotics.
They develop resistance in two ways, says Jeffrey Klausner, MD, a professor of preventive medicine at University of Southern California Keck School of Medicine who has specialized in the research of sexually transmitted diseases.
âThe organism changes its surface so that the antibiotic no longer recognizes it, or it starts to produce new enzymes that break down the antibiotic,â Klausner says. Gonorrhea, he says, has long been known as a bacteria that learns to evade antibiotics.
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Is There A Cure Or Treatment For Gonorrhea
Antibiotics have successfully treated gonorrhea for several decades however, the bacteria has developed resistance to nearly every drug used for treatment. What is the treatment for gonorrhea?
From the 2015 Sexually Transmitted Disease guidelines, the CDC recommends treatment for a gonorrhea-chlamydia coinfection with azithromycin 1 gram given orally in a single dose, plus ceftriaxone 250 mg given intramuscularly as first-line therapy.
With several doses of amoxicillin or a similar drug, gonorrhea can be cured in a few days. Antibiotics such as amoxicillin have been prescribed by doctors to treat gonorrhea in the past. Of course, even though Amoxicillin is one of the most well-known drugs, that doesnt mean that it is the primary drug of choice for treatment of gonorrhea.
Ophthalmia Neonatorum Caused By C Trachomatis
A chlamydial etiology should be considered for all infants aged 30 days who experience conjunctivitis, especially if the mother has a history of chlamydial infection. These infants should receive evaluation and age-appropriate care and treatment.
Preventing Ophthalmia Neonatorum Caused by C. trachomatis
Neonatal ocular prophylaxis with erythromycin, the only agent available in the United States for this purpose, is ineffective against chlamydial ophthalmia neonatorum . As an alternative, prevention efforts should focus on prenatal screening for C. trachomatis, including
Neonates born to mothers for whom prenatal chlamydia screening has been confirmed and the results are negative are not at high risk for infection.
Diagnostic Considerations
Treatment
Erythromycin base or ethylsuccinate 50 mg/kg body weight/day orally, divided into 4 doses daily for 14 days*
* An association between oral erythromycin and azithromycin and infantile hypertrophic pyloric stenosis has been reported among infants aged < 6 weeks. Infants treated with either of these antimicrobials should be followed for IHPS signs and symptoms.
Although data regarding use of azithromycin for treating neonatal chlamydial infection are limited, available data demonstrate that a short therapy course might be effective . Topical antibiotic therapy alone is inadequate for treating ophthalmia neonatorum caused by chlamydia and is unnecessary when systemic treatment is administered.
Follow-Up
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Is There An Over Counter Treatment For Chlamydia
No, the CDC recommended treatment for chlamydia requires a prescription, but you do not need to visit the doctors office in person to get a prescription. Technology has made doctor visits online quick and easy. Just complete an online consultation visit and a prescription can be sent to a local pharmacy.
How Do I Know If I Have Chlamydia
The only way to know if you have chlamydia is by having a chlamydia test. This involves providing a urine sample that is analysed in a laboratory. Most of the time, chlamydia doesnât have any symptoms, which is why it is important to get tested regularly, especially if you have a new sexual partner. Chlamydia symptoms can include pain when having sex, pain whilst urinating, lower stomach pain, genital discharge, tender and swollen testicles for men and bleeding in between periods for women. Only 30% of women, and 50% of men will display symptoms. It is the most common STD as it is spread unknowingly, which is why it is important to have a chlamydia test if you have a new sexual partner. If a recent sexual partner has tested positive, there is no need to get tested, and you should start treatment straight away.
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Infant Pneumonia Caused By C Trachomatis
Chlamydial pneumonia among infants typically occurs at age 13 months and is a subacute pneumonia. Characteristic signs of chlamydial pneumonia among infants include a repetitive staccato cough with tachypnea and hyperinflation and bilateral diffuse infiltrates on a chest radiograph. In addition, peripheral eosinophilia occurs frequently. Because clinical presentations differ, all infants aged 13 months suspected of having pneumonia, especially those whose mothers have a history of, are at risk for , or suspected of having a chlamydial infection should be tested for C. trachomatis and treated if infected.
Diagnostic Considerations
Specimens for chlamydial testing should be collected from the nasopharynx. Tissue culture is the definitive standard diagnostic test for chlamydial pneumonia. Nonculture tests can be used. DFA is the only nonculture FDA-cleared test for detecting C. trachomatis from nasopharyngeal specimens however, DFA of nasopharyngeal specimens has a lower sensitivity and specificity than culture. NAATs are not cleared by FDA for detecting chlamydia from nasopharyngeal specimens, and clinical laboratories should verify the procedure according to CLIA regulations . Tracheal aspirates and lung biopsy specimens, if collected, should be tested for C. trachomatis.
Treatment
Erythromycin base or ethylsuccinate 50 mg/kg body weight/day orally divided into 4 doses daily for 14 days
Azithromycin suspension20 mg/kg body weight/day orally, 1 dose daily for 3 days
Best Antibiotics To Treat It
These commonly used antibiotics for Chlamydia:
- Amoxicillin its a larger spectrum form of penicillin, amoxicillin is used for women who are breast-feeding, pregnant, or planning to become pregnant. And it can be used for those who have allergies to other medicines.
- Azithromycin Azithromycin is not related to penicillin, it is common Chlamydia medication. It is producing gastrointestinal side effects for those who related penicillin family. Azithromycin for Chlamydia is given as 2 or 4 tablets in one dose. But with Doxycycline this medicine cures up to 95% of cases of Chlamydia.
- Doxycycline This is the second most common antibiotic for Chlamydia, but its not for women who are pregnant or planning to become pregnant. Its generally given as two tablets a day for a week.
- Erythromycin This antibiotic is only used as medicine for Chlamydia for babies who have contracted the STD during birth from an infected mother.
- Levofloxacin or Ofloxacin Both of these antibiotics not for women who are planning to become pregnant. These antibiotics are usually only used as medication for Chlamydia when someone is interrupted or allergic to other forms.
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