title: Significant reduction in inflammatory response in the macaque model of chlamydial pelvic inflammatory disease with azithromycin treatment.
abstract: We inoculated 45 female macaques in the cervix with Chlamydia trachomatis once weekly for 5 weeks and randomly assigned them to treatment with doxycycline (n=12), azithromycin (n=12), or placebo (n=21). At hysterectomy, cervical cultures remained positive in 12 of 21 placebo-treated monkeys, versus 0 of 12 doxycycline- or azithromycin-treated monkeys (P<.01); cervical ligase chain reaction remained positive in 15 placebo-, 1 doxycycline-, and 0 azithromycin-treated monkeys. Tubal swabs remained positive in 3 placebo-, 1 doxycycline-, and 0 azithromycin-treated monkeys. Immunopathologic damage was moderate to widespread in upper and lower reproductive-tract tissues from placebo- and doxycycline-treated monkeys but were significantly reduced in azithromycin-treated monkeys. Transforming growth factor- beta was also significantly less prevalent in azithromycin-treated monkeys. Azithromycin treatment dramatically reduced the inflammatory response and was highly effective in eradicating C. trachomatis from the lower and upper reproductive tract (12/12), compared with doxycycline (7/12) and placebo (3/21).
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington 98195-6460, USA. dpatton@u.washington.edu
authors.forename: Dorothy L
authors.initials: DL
authors.lastname: Patton
authors.forename: Yvonne T Cosgrove
authors.initials: YT
authors.lastname: Sweeney
authors.forename: Walter E
authors.initials: WE
authors.lastname: Stamm
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000188:drug therapy* / Q000503:physiopathology*; D002692:Chlamydia trachomatis; D005260:Female; D008254:Macaca nemestrina; D000292:Pelvic Inflammatory Disease / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology*
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin