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Sexually Transmitted Infections  |  Infections by Chlamydia trachomatis

Infections by Chlamydia
trachomatis

Administration

Guidelines

Epidemiology

Risk Factors

Tab Number 5

Efficacy

Administration

Adults1

Single 1000 mg dose

  • ZITHROMAX should be given as a single daily dose1
  • ZITHROMAX tablets and suspension can be taken with or without food1
Renal Impairment1

No dose adjustment is necessary in patients with mild to moderate renal impairment (glomerular filtration rate [GFR] of 10–80 mL/min). Caution should be exercised when ZITHROMAX is administered to patients with severe renal impairment (GFR <10 mL/min)

Hepatic Impairment1

The same dosage as in patients with normal hepatic function may be used in patients with mild to moderate hepatic impairment

GuidelinesAzithromycin: recommended in a variety of infection control guidelinesAzithromycin is recommended as a treatment option in the following guidelines: Management of Chlamydia trachomatis Infections2

European Guidelines 2015

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WHO Guidelines for the  Management of Sexually  Transmitted Infections3

World Health Organization 2021

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Sexually Transmitted Diseases Treatment Guidelines4

Centers for Disease Control and Prevention (CDC) 2021

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Epidemiology

In 2021, chlamydia infection was the most frequently reported bacterial infection disease in the United States4

Two-thirds of new chlamydial infections occur among youth aged 15-24 years. It is estimated that 1 in 20 sexually active young women aged 14-24 years has chlamydia.5

In a 2015 meta-analysis of data from 11 European and five other high-income countries, the pooled average of chlamydia point prevalence estimates was 3.6% in women and 3.5% in men6

Risk Factors7
  • Age: sexually active adolescents and young adults
  • Multiple/casual sexual partners
  • Lack of barrier contraception
  • Young age at first intercourse
  • Ethnicity: non-white have increased risk compared with white
EfficacyZITHROMAX – A single dose is as effective as 1 week of twice-daily doxycycline when treating chlamydia8 Clinical Cure Week 2

Adapted from Nilsen et al. 19928

C. trachomatis Eradication Rates Week 2

Adapted from Nilsen et al. 19928

Nilsen et al. 19928
  • In a multicenter, randomized, double-blind study of single-dose azitrhomycin and doxycycline in the treatment of chlamydial urethritis in males, patients received either 1,000 mg azithromycin as single dose or doxycycline 100 mg twice-daily for 7 days
  • There was no significant difference (p<0.05) in clinical response between treatments
  • Clinical cure at Week 1 was recorded in 28/44 (64%) azithromycin and 29/42 (69%) doxycycline-treated subjects. 
  • Clinical cure rates at Week 2 were 31/35 (89%) for azithromycin and 32/34 (94%) for doxycycline
  • Bacteriological eradication rates for C. trachomatis at Week 1 were 44/44 and 42/42 in azithromycin and doxycycline-treated patients, respectively; eradication rates at Week 2 were 35/35 and 34/34, respectively
ZITHROMAX is contraindicated in patients with a known hypersensitivity to azithromycin, erythromycin, any macrolide or ketolide antibiotic, or to any of the excipients.1
The most recent local resistance data available must always take precedence when selecting antimicrobial therapy; in settings where local resistance data are not available, national and international guidelines can help inform antimicrobial choice.
As with any antibiotic preparation, observation for signs of superinfection with non-susceptible organisms including fungi is recommended. Clostridium difficile associated diarrhea has been reported with azithromycin, and may range in severity from mild diarrhea to fatal colitis.1
The prevalence of acquired resistance to azithromycin may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections. Expert advice should be sought when the local prevalence of resistance is such that the utility of azithromycin in at least some types of infections is questionable.1
In patients with severe renal impairment (GFR <10 mL/min), a 33% increase in systemic exposure to ZITHROMAX was observed.1
You might also be interested in...Sexually Transmitted Infections Infections by Neisseria 
gonorrhoeae
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Sexually Transmitted Infections Chancroid/Genital Ulcers Men Find out moreLoading
Resources ZITHROMAX® Mode of Action Find out moreLoadingReferences:Pfizer Malaysia ZITHROMAX Prescribing Information. Available at: https://labeling.pfizer.com/ShowLabeling.aspx?id=17705. Accessed January 2024.Lanjouw E, et al. Int J STD AIDS. 2016;27(5):333–48.World Health Organization. Guidelines for the management of symptomatic sexually transmitted infections. Gevena: 2021. Licence: CC BY-NC-SA 3.0 IGO.Workowski KA, et al. MMWR Recomm Rep. 2021;70(4):1–192.Centers for Disease Control and Prevention. Chlamydia – Detailed Fact Sheet 2023. Available at: https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm#:~:text=Two%2Dthirds%20of%20new%20chlamydial,youth%20aged%2015%2D24%20years.&text=Estimates%20show%20that%201%20in,14%2D24%20years%20has%20chlamydia.&text=Disparities%20persist%20among%20racial%20and,six%20times%20that%20of%20Whites. Accessed June 2023.Redmond S, et al. PLoS One. 2015;10(1):e0115753.Navarro C, et al. Can J Infect Dis. 2002;13(3):195–207.Nilsen A, et al. Genitourin Med. 1992;68:325–7.
Sexually Transmitted Infections ZITHROMAX® Safety Information Find out more Loading
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