MULTICENTER TRIAL OF SINGLE-DOSE AZITHROMYCIN VS CEFTRIAXONE IN THE TREATMENT OF UNCOMPLICATED GONORRHEA

被引:113
作者
HANDSFIELD, HH
DALU, ZA
MARTIN, DH
DOUGLAS, JM
MCCARTY, JM
SCHLOSSBERG, D
ARNO, JN
MROCZKOWSKI, TF
VINER, BL
MILLS, J
GARRISON, NA
VERDON, MS
WIGGINS, S
EHRET, M
机构
[1] SEATTLE KING CTY DEPT PUBL HLTH, SEATTLE, WA USA
[2] ST LOUIS DEPT HLTH, ST LOUIS, MO USA
[3] LOUISIANA STATE UNIV, NEW ORLEANS, LA USA
[4] DENVER DIS CONTROL SERV, DENVER, CO USA
[5] UNIV COLORADO, DENVER, CO 80202 USA
[6] CALIF MED RES GRP, FRESNO, CA USA
[7] FRESNO CTY HLTH DEPT, FRESNO, CA USA
[8] EPISCOPAL HOSP, PHILADELPHIA, PA USA
[9] MED COLL PENN, PHILADELPHIA, PA 19129 USA
[10] INDIANA UNIV, INDIANAPOLIS, IN 46204 USA
[11] BOSTON CITY HOSP, BOSTON, MA 02118 USA
[12] SAN FRANCISCO GEN HOSP, SAN FRANCISCO, CA 94110 USA
[13] NATL IND, MONTGOMERY, AL USA
关键词
D O I
10.1097/00007435-199403000-00010
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background and Objectives: Azithromycin is a new, long-acting azalide antibiotic that is active against Neisseria gonorrhoeae. A single oral dose of 1.0 g is effective against uncomplicated genital infection with Chlamydia trachomatis. Goal of this Study: To compare the efficacy and tolerance of single-dose treatment of uncomplicated gonorrhea with azithromycin, 2.0 g orally, and ceftriaxone, 250 mg intramuscularly. Study Design: Seven hundred twenty-four men and women with presumptive, uncomplicated gonorrhea were treated with azithromycin 2.0 g orally or ceftriaxone 250 mg intramuscularly in a 2:1 ratio in a multicenter, open, randomized control trial in 10 public sexually transmitted disease clinics in the United States. Patients were followed up in 5 to 9 days and, for a subset of patients, 12 to 18 days after treatment. The main outcome measures were the isolation of N. gonorrhoeae and C. trachomatis and patient-reported side effects. Results: Among infected patients who returned for follow-up, N. gonorrhoeae was eradicated from all anatomic sites in 370 of 374 (98.9%; 95% confidence interval [95%CI] 97.9%-100%) treated with azithromycin and 171 of 175 (97.7%; 95%CI 95.5%-99.9%) given ceftriaxone. Treatment with either drug was effective in all 73 patients infected with P-lactamase-producing N. gonorrhoeae. Chlamydial infection was eradicated in all 17 patients given azithromycin who returned and were recultured at follow-up and in two of seven patients given ceftriaxone (P < 0.001). Gastrointestinal side effects occurred in 35.3% (95%CI 30.7%-39.8%) of patients given azithromycin; of those with symptoms, these were moderate in 10.1% and severe in 2.9%. Conclusions: Azithromycin 2.0 g and ceftriaxone 250 mg are equally effective in the treatment of uncomplicated gonorrhea. Azithromycin was associated with a relatively high frequency of gastrointestinal side effects and is expensive, but it has the advantages of oral administration and efficacy against concomitant chlamydial infection.
引用
收藏
页码:107 / 111
页数:5
相关论文
共 16 条