Title |
Is it time to switch to doxycycline from azithromycin for treating genital chlamydial infections in women? Modelling the impact of autoinoculation from the gastrointestinal tract to the genital tract
|
---|---|
Published in |
BMC Infectious Diseases, April 2015
|
DOI | 10.1186/s12879-015-0939-3 |
Pubmed ID | |
Authors |
Andrew P Craig, Fabian YS Kong, Laxmi Yeruva, Jane S Hocking, Roger G Rank, David P Wilson, Basil Donovan |
Abstract |
Single-dose azithromycin is recommended over multi-dose doxycycline as treatment for chlamydial infection. However, even with imperfect adherence, doxycycline is more effective in treating genital and rectal infection. Recently, it has been suggested that autoinoculation from the rectum to the genitals may be a source of persistent chlamydial infection in women. We estimated the impact autoinoculation may have on azithromycin and doxycycline effectiveness. We estimate treatment effectiveness using a simple mathematical model, incorporating data on azithromycin and doxycycline efficacy from recent meta-analyses, and data on prevalence of rectal infection in women with genital chlamydial infection. When the possibility of autoinoculation is taken into account, we calculate that doxycycline effectiveness may be 97% compared to just 82% for azithromycin. Consideration should be given to re-evaluating azithromycin as the standard treatment for genital chlamydia in women. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 30 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 4 | 13% |
Student > Postgraduate | 4 | 13% |
Student > Bachelor | 3 | 10% |
Student > Master | 3 | 10% |
Student > Doctoral Student | 2 | 7% |
Other | 6 | 20% |
Unknown | 8 | 27% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 8 | 27% |
Agricultural and Biological Sciences | 4 | 13% |
Nursing and Health Professions | 3 | 10% |
Immunology and Microbiology | 3 | 10% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
Other | 1 | 3% |
Unknown | 10 | 33% |