Is azithromycin adequate treatment for asymptomatic rectal chlamydia?
Is azithromycin adequate treatment for asymptomatic rectal chlamydia?
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DOI：
10.1258/ijsa.2011.010490
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发表时间：
2011-08-01
影响因子：
1.4
通讯作者：
Donovan, B.
中科院分区：
文献类型：
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作者：
Drummond, F.;Ryder, N.;Donovan, B.
直肠衣原体是一种常见的性传播感染（STI）的男性与男性发生性关系（MSM），主要是无症状。推荐的阿奇霉素1 g单次口服治疗尚未进行随机试验，因此其疗效尚不清楚。我们对2009年在悉尼性健康中心诊断为无症状直肠衣原体的所有MSM进行了回顾性病例记录审查。我们确定了116名接受阿奇霉素的MSM; 85名（73%）在不同时间（中位数78天，范围21-372天）参加了推荐的复检。在返回的男性中，11例（13%）有持续阳性结果;我们回顾了行为数据，将这些男性归类为可能的再感染（6/11）或可能的治疗失败（5/11），表明疗效为94%。在进行随机对照试验（RCT）之前，应鼓励直肠衣原体患者在6-12周时参加复检。
Rectal chlamydia is a common sexually transmissible infection (STI) in men who have sex with men (MSM) that is predominantly asymptomatic. The recommended treatment of azithromycin 1 g as a single oral dose has not been subject to randomized trials and so its efficacy is unknown. We conducted a retrospective case-note review of all MSM diagnosed at the Sydney Sexual Health Centre with asymptomatic rectal chlamydia in 2009. We identified 116 MSM who received azithromycin; 85 (73%) attended for the recommended re-test at varying times (median 78 days, range 21-372 days). Of the men who returned, 11 (13%) had a persistently positive result; we reviewed behavioural data to classify these men as probable re-infections (6/11) or possible treatment failures (5/11), suggesting an efficacy of 94%. Until a randomized controlled trial (RCT) is conducted, patients with rectal chlamydia should be encouraged to attend for a re-test at 6-12 weeks.