Drummond F, Ryder N, Wand H, Guy R, Read P, McNulty A M, Wray L, Donovan B
The Kirby Institute, University of NSW, Sydney, Australia.
Int J STD AIDS. 2011 Aug;22(8):478-80. doi: 10.1258/ijsa.2011.010490. Epub 2011 Jul 8.
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.
直肠衣原体感染是男男性行为者（MSM）中一种常见的性传播感染（STI），主要表现为无症状。推荐的阿奇霉素单剂量口服1克治疗方案尚未经过随机试验，因此其疗效未知。我们对2009年在悉尼性健康中心被诊断为无症状直肠衣原体感染的所有男男性行为者进行了回顾性病例记录审查。我们确定了116名接受阿奇霉素治疗的男男性行为者；其中85人（73%）在不同时间（中位数78天，范围21 - 372天）接受了推荐的复查。在回来复查的男性中，11人（13%）结果持续呈阳性；我们审查了行为数据，将这些男性分类为可能的再次感染（6/11）或可能的治疗失败（5/11），提示疗效为94%。在进行随机对照试验（RCT）之前，应鼓励直肠衣原体感染患者在6 - 12周时进行复查。
