Great question! One of my students did her grand rounds on this very topic last year.
for asymptomatic CT, ie found on screening with no symptoms, azithro seems to do just fine. For those with symptomatic CT, ie proctitis, tenesmus, colitis, doxy is where its at.Here are some references that she shared.
1) Khosropour, C., Dombrowski, J., Barbee, L., Manhart, L., & Golden, M. (2014). Comparing azithromycin and doxycycline for the treatment of rectal chlamdyial infection: A retrospective cohort study.
Sexually Transmitted Disease 41(2), 79-85. doi:10.1097/OLQ.0000000000000088. (some highlights from it)
---1231 were treated with azithromycin and 249 treated with doxycycline.
---407/1231 of azithromycin group re-tested AND 88 still had the infection
---95/249 of doxycycline group re-tested AND 8 still had the infection.
2) Hamly, E. & Taylor, C. (2006). Sexually transmitted proctitis.
Postgrad Med Journal 82, 733-736. doi: 10.1136/pmj.2006.048488
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Angela Kapalko
Physician Assistant Chairperson for AAHIVM
Philadelphia FIGHT CommunityHealth Centers
Philadelphia PA
akapalko@fight.org------------------------------
Original Message:
Sent: 03-25-2020 09:21
From: Shannon Stewart
Subject: Rectal Chlamydia Treatment
Good morning All.
I recently had a msm test positive for rectal chlamydia. I ordered the Azithromycin per usual. I was told by triage that Doxycycline is the recommended new option for rectal chlamydia due to absorption. I had not heard this news. I am wondering if any of you could speak on this subject.
Thank you
Shannon
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Shannon Stewart, ARNP, AAHIV
Siouxland Community Health Center
Sioux City, Iowa
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