< > Home : FAQ : Professional : Chlamydiales : Immunobiology : Infections : Diagnosis & Treatment : Links : Contact Us

Treatment of chlamydial infections

Tetracyclines have been the mainstay of anti-chlamydial therapy, for over 20 years. They are the yardstick by which other anti-chlamydial drugs are assessed. The current Centers for Disease Control and Prevention (CDC) recommendation is oral doxycycline 100 mg twice a day for seven days [CDC, 1993 & 1998].  Chlamydial eradication following a proper course of the drug is > 90% in uncomplicated infection, but, as for the macrolides and quinolones, clinical cure rate (relief of symptoms) is substantially less. This differs from the 100 mg once daily dose of doxycycline used for most other conditions; there is little advantage in prolonging the course [Ridgway, 1997], particularly as this increases the risk of side effects which may include gastrointestinal disturbance and antibiotic-induced suppression of the normal vaginal bacterial flora leading to the overgrowth of the yeast Candida albicans (thrush). 

For acute upper genital tract infection, such as pelvic inflammatory disease, intravenous therapy may be necessary. However, intravenous preparations of doxycycline are not available in some countries, including the UK, necessitating the use of intravenous tetracycline hydrochloride [Ridgway, 1998]. Despite isolated reports, chlamydial resistance to the tetracyclines has not been a significant clinical problem [see: chlamydial antibiotic resistance]. The tetracyclines are also reasonably effective against Mycoplasma sp. and against Ureaplasma urealyticum, although the importance of these organisms in genital tract infection is not fully understood.

[MEW] May 2002

NEXT: The Macrolide antibiotics, including azithromycin and erythromycin. 

References

Ridgway, G. L. (1998). Treatment of Chlamydia trachomatis infections. 4^th Bandolier Conference on Evidence Based Medicine.

NEXT: The Macrolide antibiotics, including azithromycin and erythromycin.