title: Is azithromycin adequate treatment for asymptomatic rectal chlamydia?
abstract: 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.
authors: The Kirby Institute, University of NSW, Sydney, Australia. fdrummond@kirby.unsw.edu.au
authors: F
authors: F
authors: Drummond
authors: N
authors: N
authors: Ryder
authors: H
authors: H
authors: Wand
authors: R
authors: R
authors: Guy
authors: P
authors: P
authors: Read
authors: A M
authors: AM
authors: McNulty
authors: L
authors: L
authors: Wray
authors: B
authors: B
authors: Donovan
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D058345:Asymptomatic Infections / Q000628:therapy*; D017963:Azithromycin / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000175:diagnosis / Q000188:drug therapy*; D002692:Chlamydia trachomatis; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin