多西环素 100 毫克，每日 2 次，连服 7 天，和阿奇霉素 1 克单次剂量，治疗男男性行为者直肠沙眼衣原体感染的疗效。

Effectiveness of doxycycline 100 mg twice daily for 7 days and azithromycin 1 g single dose for the treatment of rectal Chlamydia trachomatis infection among men who have sex with men.

机构信息

AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.

Center for AIDS Research, Kumamoto University, Kumamoto, Japan.

出版信息

J Antimicrob Chemother. 2021 Jan 19;76(2):495-498. doi: 10.1093/jac/dkaa437.

DOI:10.1093/jac/dkaa437

PMID:33147327

Abstract

OBJECTIVES

To compare the effectiveness of doxycycline 100 mg twice daily for 7 days and azithromycin 1 g single dose for the treatment of rectal Chlamydia trachomatis infection among MSM in a real clinical setting.

METHODS

A prospective study was performed to compare the effectiveness of doxycycline and azithromycin for the treatment of rectal C. trachomatis among MSM in Tokyo, Japan. Subjects diagnosed with rectal C. trachomatis infection were treated and test-of-cure examination (TOC) was performed at least 3 weeks after the treatment. Treatment of rectal C. trachomatis infection was decided prospectively in a time-dependent manner; in the period between January 2017 and October 2018, azithromycin was administered to all subjects, whereas from October 2018 through March 2020, doxycycline was administered to all subjects. Effectiveness of these treatments was calculated by the number of rectal C. trachomatis-negative subjects at TOC divided by the number of subjects treated.

RESULTS

Two hundred and ninety-six MSM with rectal C. trachomatis infection were treated with azithromycin (80 patients) and doxycycline (216 patients) in a time-dependent manner. Of the 296 MSM, 274 (92.6%) were treated successfully [67 (83.7%, 95% CI = 79.6%-87.9%) in the azithromycin group versus 207 (95.8%, 95% CI = 94.5%-97.2%) in the doxycycline group, P < 0.001]. To evaluate factors associated with treatment failure, we performed logistic regression analysis. In univariate and multivariate analysis, only doxycycline treatment was inversely associated with treatment failure (OR = 0.29, 95% CI = 0.084-0.976, P = 0.046).

CONCLUSIONS

The treatment with doxycycline 100 mg twice daily for 7 days was superior to that with azithromycin 1 g single dose for rectal C. trachomatis among MSM in a real-world setting.

摘要

目的

比较多西环素 100mg 每日 2 次连用 7 天与单次阿奇霉素 1g 治疗男男性行为者（MSM）直肠沙眼衣原体感染的疗效。

方法

在日本东京进行了一项前瞻性研究，比较了多西环素和阿奇霉素治疗 MSM 直肠沙眼衣原体感染的疗效。对确诊为直肠沙眼衣原体感染的受试者进行治疗，并在治疗后至少 3 周进行治疗后检测（TOC）。直肠沙眼衣原体感染的治疗是在时间依赖的基础上进行前瞻性决定的；在 2017 年 1 月至 2018 年 10 月期间，所有受试者均给予阿奇霉素治疗，而在 2018 年 10 月至 2020 年 3 月期间，所有受试者均给予多西环素治疗。通过 TOC 时直肠沙眼衣原体阴性受试者的数量除以接受治疗的受试者的数量来计算这些治疗方法的有效性。

结果

296 例 MSM 直肠沙眼衣原体感染患者以时间依赖性方式接受阿奇霉素（80 例）和多西环素（216 例）治疗。在 296 例 MSM 中，274 例（92.6%）治疗成功[阿奇霉素组 67 例（83.7%，95%CI=79.6%-87.9%），多西环素组 207 例（95.8%，95%CI=94.5%-97.2%），P<0.001]。为了评估与治疗失败相关的因素，我们进行了逻辑回归分析。在单因素和多因素分析中，只有多西环素治疗与治疗失败呈负相关（OR=0.29，95%CI=0.084-0.976，P=0.046）。