Geisler William M
Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA.
Clin Infect Dis. 2007 Apr 1;44 Suppl 3:S77-83. doi: 10.1086/511421.
In April 2005, in preparation for the 2006 Centers for Disease Control and Prevention (CDC) sexually transmitted diseases (STD) treatment guidelines, the CDC convened an advisory group to examine recent abstracts and published literature addressing management of Chlamydia trachomatis infections in adolescents and adults. Key questions were posed and answered on the basis of quality of evidence and expert opinion. Clinical trials continue to demonstrate equivalent efficacy and tolerability of azithromycin and doxycycline regimens, and both remain recommended as first-line therapy in nonpregnant individuals. More data and clinical experience are available to support the efficacy, safety, and tolerability of azithromycin in pregnant women, and, in the upcoming guidelines, azithromycin will be recommended as first-line therapy for such patients. Evidence is building that expedited partner therapy (EPT), with provision of treatment or a prescription, may be just as effective as or more effective than standard partner referral in ensuring partner treatment and preventing chlamydia recurrence in women. Although there are more studies needed and barriers to be addressed before its widespread use, EPT will be recommended as an option for partner management.
2005年4月,为编写2006年美国疾病控制与预防中心(CDC)性传播疾病(STD)治疗指南,CDC召集了一个咨询小组,对近期有关青少年和成人沙眼衣原体感染管理的摘要及已发表文献进行审查。基于证据质量和专家意见提出并回答了关键问题。临床试验继续表明阿奇霉素和多西环素治疗方案具有同等疗效和耐受性,两者仍被推荐为非孕妇的一线治疗药物。有更多数据和临床经验支持阿奇霉素在孕妇中的疗效、安全性和耐受性,在即将出台的指南中,阿奇霉素将被推荐为此类患者的一线治疗药物。越来越多的证据表明,在确保性伴侣接受治疗并预防女性衣原体复发方面,提供治疗或处方的加速性伴侣治疗(EPT)可能与标准性伴侣转诊同样有效或更有效。尽管在广泛应用之前还需要更多研究并解决一些障碍,但EPT将被推荐作为性伴侣管理的一种选择。