CHLAZIDOXY
Trial question
Is doxycycline superior to azithromycin in female patients with concurrent anorectal and vaginal C. trachomatis infection?
Study design
Multi-center
Open label
RCT
Population
357 female patients
Inclusion criteria: adult female patients positive for anorectal and vaginal C. trachomatis infection
Key exclusion criteria: symptoms suggestive of pelvic inflammatory disease; receipt of antibiotic with antichlamydial activity within 21 days of screening; lactation; severe liver or cardiac disease
Interventions
N=184 doxycycline (100 mg twice per day for 7 days)
N=173 azithromycin (a single 1 g dose)
Primary outcome
Microbiological anorectal cure
94
85
94.0 %
70.5 %
47.0 %
23.5 %
0.0 %
Doxycycline
Azithromycin
Significant
increase ▲
NNT = 11
Significant increase in microbiological anorectal cure (94% vs. 85%; OR 2.33, 95% CI 1.1 to 4.76)
Safety outcomes
No significant difference in adverse events including gastrointestinal disorders; serious adverse effects.
Conclusion
In adult female patients positive for anorectal and vaginal C. trachomatis infection, doxycycline was superior to azithromycin with respect to microbiological anorectal cure.
Reference
Olivia Peuchant, Edouard Lhomme, Pervenche Martinet et al. Doxycycline versus azithromycin for the treatment of anorectal Chlamydia trachomatis infection in women concurrent with vaginal infection (CHLAZIDOXY study): a multicentre, open-label, randomised, controlled, superiority trial. Lancet Infect Dis. 2022 Aug;22(8):1221-1230.
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