Treatment of concomitant eye and genital chlamydial infection with erythromycin and roxithromycin.

A single blind study of 10 days' randomly allocated treatment with erythromycin (1000 mg/day) and roxithromycin (300 mg/day) in 14 (group A) and 13 (group B) adults, respectively, all with culture-proven chlamydial conjunctivitis was performed. For comparison, 14 days' treatment with 1 g erythromycin daily given to 35 adults (Group C) with chlamydial conjunctivitis was also evaluated. Follow-up was made approximately one month after start of therapy. Only 2 of the 37 men and 1 of the 25 women studied, all of whom had signs of conjunctivitis, had noticed concomitant symptoms of infection from the genital tract. Nasopharyngeal cultures were chlamydia-positive in 7 (50%), 7 (54%) and 20 (57%) of the patients in Group A, B and C, respectively, while for genital cultures the corresponding figures were 9 (64%), 8 (62%) and 23 (66%), respectively. The course with erythromycin in group C cured the conjunctivitis in 34 (97%) of the patients both clinically and microbiologically. Ten days' treatment with the same dose (Group A) did not eradicate chlamydiae from the eye in one, from the nasopharynx in 5 and from the genital tract in still another patient. The roxithromycin treatment (Group B) resulted in negative chlamydial cultures from the eyes in all 13 cases, while the nasopharyngeal and genital cultures were still positive in one patient each. The study showed that in spite of the eye being cured by macrolide therapy, other sites like the nasopharynx and the genital tract may still be colonized, why sampling for C. trachomatis from these sites should be made in tests for cure in chlamydial conjunctivitis cases.(ABSTRACT TRUNCATED AT 250 WORDS)