Azithromycin and sexually transmitted diseases caused by Chlamydia trachomatis and Neisseria gonorrhoeae

Abstract

Objective: to assess the efficacy and safety of azithromycin in the treatment of sexually transmitted diseases (STD) causes by Chlamydia trachomatis and Neisseria gonorrhoeae.
Design: prospective, open, non-comparative study.
Setting: outpatient clinics of participating institutions.
Patients: 50 outpatients with clinical diagnosis microbiologically confirmed, employing ELISA test for Chlamydia trachomatis and selective cultures for Neisseria gonorrhoeae.
Intervention: treatment with single oral dose or azithromycin, 1 gr. No other antibiotic treatment was allowed.
Main outcome measure: cure of symptoms and eradication of pathogens found.
Results: predominance of female patients; although the studied population were highly promiscual (it included sexual workers), we found 5 totally asymptomatic female patients, all with Chlamydia trachomatis and one with associated gonococcus. The majority of patients presented Chlamydial infection alone (83%), followed by mixed infections (14%) and only one case of single gonococcal infection.
Clinical assessments: cure plus improvement was appreciated within first 48 hours in half of the patients, that increased up to 93% at the end of 7•10 days of follow-up. 7% remained symptomatic due to reinfection (two patients) and persistence (one).
Microbiological: eradication was obtained in 96% of the cases. Cases with reinfection and
persistence were due to Chlamydia. AH cured after a second dose of azithromycin.
Compliance: of 50 patients that received treatment, 48 (96%) returned to controls.
Safety: 3 patients presented mild side effects, dizziness, nausea and diarrhea each; none required treatment.
Conclusions: standardizing treatment of STD's caused by chlamydia trachomatis and Neisseria gonorrhoeae single 1 gr of oral azithromycin, with its optimal compliance and high rates of clinical and microbiological efficacy will help the health authorities all around the world in keeping this endemic disease in control.