Article

Correlation between culture testing of swabs and ligase chain reaction of first void urine from patients recently treated for Chlamydia trachomatis.

The Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada.
Sexually Transmitted Infections (Impact Factor: 2.61). 07/2003; 79(3):237-9. DOI: 10.1136/sti.79.3.237
Source: PubMed

ABSTRACT We assessed the correlation between ligase chain reaction (LCR) on first void urine (FVU) and cultures of urethral and cervical swabs to detect chlamydia during three post-treatment follow up visits for 10 men and 19 women with genital chlamydial infections who had been treated with azithromycin or doxcycline.

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    ABSTRACT: Background. There's been recent debate questioning the efficacy of azithromycin for the treatment of urogenital chlamydia infection. We conducted a meta-analysis to compare the efficacy of 1 gram azithromycin with 100 mg doxycycline twice daily (seven days) for the treatment of urogenital chlamydia infection. Methods. Medline, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane reviews and CINHAL were searched until 31 December 2013. Randomized controlled trials comparing azithromycin with doxycycline for the treatment of genital chlamydia with evaluation of microbiological cure within three months of treatment were included. Gender, diagnostic test, follow-up time, attrition, patient symptomatic status and microbiological cure were extracted. The primary outcome was the difference in efficacy at final follow-up. Study bias was quantitatively and qualitatively summarized. Results. 23 studies were included evaluating 1147 and 912 patients for azithromycin and doxycycline respectively. We found a pooled efficacy difference in favor of doxycycline of between 1.5% (95%CI:-0·1%,3·1%; I(2) =1·9%,p=0·435; random effects) and 2·6% (95%CI:0·5%,4·7%; fixed effects) . Sub-group analyses showed the fixed effects pooled efficacy difference for symptomatic men was 7·4% (95%CI: 2·0%,12·9%) and the random effects was 5·5% (95%CI: -1·4%,12·4%). Conclusions. There may be a small increased efficacy of up to 3% for doxycycline compared with azithromycin for the treatment of urogenital chlamydia and about 7% increased efficacy for doxycycline for the treatment of symptomatic urethral infection in men. However, the quality of the evidence varies considerably with few double blind placebo controlled trials conducted. Given increasing concern about potential azithromycin failure, further well designed and statistically powered, double blind, placebo controlled trials are needed.
    Clinical Infectious Diseases 04/2014; · 9.37 Impact Factor

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