COMPARISON OF AZITHROMYCIN AND DOXYCYCLINE IN THE TREATMENT OF NONGONOCOCCAL URETHRITIS IN MEN

Azithromycin has activity in vitro against Chlamydia trachomatis, and its novel pharmacokinetics suggest that even single doses may be effective in the treatment of non-gonococcal urethritis (NGU). This study compared the efficacy and safety of a single 1 g oral dose of azithromycin versus doxycycline 100 mg bid for seven days in the treatment of NGU. Men with symptoms and/or signs of NGU, and with ≥ 5 polymorphonuclear leucocytes/high-power field in a Gram's-stained urethral smear, were recruited. Investigations included endourethral swabs for C. trachomatis cell culture. Patients were randomized to receive azithromycin or doxycycline, and were re-assessed on day 7–10 and on day 14–21. Of the 143 men recruited, C. trachomatis was isolated from 51 (40%) of the 128 evaluable patients. Both treatments were well tolerated and had comparable cure rates. Azithromycin 1 g appears to be an effective and safe alternative to doxycycline for the treatment of chlamydial and nonchlamydial urethritis, and its single-dose administration is an advantage in terms of patient compliance. © 1993, The British Society for Antimicrobial Chemotherapy.