Romanowski B, Talbot H, Stadnyk M, Kowalchuk P, Bowie W R
Sexually Transmitted Disease Services, Alberta Health, Edmonton, Alberta, Canada.
Ann Intern Med. 1993 Jul 1;119(1):16-22. doi: 10.7326/0003-4819-119-1-199307010-00003.
To compare the efficacy and tolerability of minocycline versus doxycycline in the treatment of nongonococcal urethritis and mucopurulent cervicitis.
Randomized, double-blind trial.
Sexually transmitted disease clinics.
151 men and 102 women with nongonococcal urethritis, mucopurulent cervicitis or whose sexual partner had either condition or a positive culture for Chlamydia trachomatis.
Minocycline, 100 mg nightly, or doxycycline, 100 mg twice daily, each administered for 7 days.
At each visit (days 14 +/- 3, 28 +/- 5, and 49 +/- 7) patients were questioned regarding symptoms, signs, drug compliance, and sexual contact. Cultures for C. trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis were obtained at each visit.
253 patients were enrolled (133, doxycycline; 120, minocycline). Chlamydia trachomatis was initially isolated from 31% of men and 39% of women. Men with a positive smear had a higher symptom/sign score (P < 0.001) and were more likely to have chlamydia (P = 0.004). Positive endocervical smears were not associated with symptoms or signs (P > 0.2) but correlated with isolation of chlamydia (P < 0.001). One hundred sixty-two patients (64%) completed the study. The proportion with urethritis or cervicitis did not differ by treatment group at any follow-up visit (P > 0.08). Unprotected sexual contact did not affect clinical or microbiological cure rates. Adverse effects occurred more frequently in the doxycycline group (men: 43% versus 26%; P = 0.05; women: 62% versus 35%; P = 0.009). Although the proportion with dizziness did not differ by drug administered (P = 0.1), dizziness was reported more often by women (11% versus 3%).
Minocycline, 100 mg nightly, was as effective as doxycycline, 100 mg twice daily, each given for 7 days in the treatment of nongonococcal urethritis and mucopurulent cervicitis. Vomiting and gastrointestinal upset occurred more frequently in the doxycycline group.
比较米诺环素与多西环素治疗非淋菌性尿道炎和黏液脓性宫颈炎的疗效及耐受性。
随机双盲试验。
性传播疾病诊所。
151名男性和102名女性，患有非淋菌性尿道炎、黏液脓性宫颈炎，或其性伴侣患有上述疾病之一或沙眼衣原体培养阳性。
米诺环素，每晚100毫克；或多西环素，每日两次，每次100毫克，均服用7天。
每次随访（第14±3天、第28±5天和第49±7天）时，询问患者症状、体征、药物依从性和性接触情况。每次随访时采集沙眼衣原体、解脲脲原体和人型支原体培养样本。
共纳入253例患者（多西环素组133例；米诺环素组120例）。最初从31%的男性和39%的女性中分离出沙眼衣原体。涂片阳性的男性症状/体征评分更高（P<0.001），且更易感染衣原体（P = 0.004）。宫颈涂片阳性与症状或体征无关（P>0.2），但与衣原体分离相关（P<0.001）。162例患者（64%）完成了研究。在任何随访中，尿道炎或宫颈炎的比例在治疗组间无差异（P>0.08）。无保护的性接触不影响临床或微生物学治愈率。多西环素组不良反应发生率更高（男性：43%对26%；P = 0.05；女性：62%对35%；P = 0.009）。虽然头晕的比例在用药组间无差异（P = 0.1），但女性报告头晕的频率更高（11%对3%）。
每晚服用100毫克米诺环素与每日两次、每次服用100毫克多西环素，均服用7天，在治疗非淋菌性尿道炎和黏液脓性宫颈炎方面疗效相当。多西环素组呕吐和胃肠道不适发生率更高。
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