Active Ingredients: Doxycycline
If we are to reduce the burden of genital chlamydia, treatment for rectal chlamydia must be efficacious.
This highlights the need for randomized controlled trial evidence comparing azithromycin with doxycycline for the treatment of rectal chlamydia.
Eligible participants will undergo standard care in their trimonthly visit recommended by STI testing guideline, and complete informed consent and a baseline survey.
They will be given daily dose of 100 mg oral doxycycline for 3 months during the visit, and instruction of how to take the medicine.
Performance of chlamydia screening tests Lastly, a proportion of rectal chlamydia treatment failure cases diagnosed are likely to be false positives.
Nucleic acid amplification tests are highly sensitive and do not differentiate between live and dead chlamydial nucleic acid, and it has been shown that chlamydia DNA and rRNA can be detected for several weeks after treatment.
Discussion and conclusions So what does this mean for the treatment of rectal chlamydia infection? We urgently need RCT evidence comparing azithromycin with doxycycline for the treatment of rectal chlamydia.
Studies suggest that a longer duration of azithromycin and doxycycline can reduce the development of heterotypic resistance in vivo 34 and can overcome penicillin-induced persistence. If you forget to take a dose, take it as soon as you remember, unless it's nearly time for your next dose.
In this case, just leave out the missed dose and take your next dose as normal.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
You could also ask your pharmacist for advice on other ways to remember your medicines. What if I take too much?
Accidentally taking an extra dose of doxycycline is unlikely to harm you. Speak to your pharmacist or doctor if you're worried or you take more than 1 extra dose. Side effects Like all medicines, doxycycline can cause side effects, although not everyone gets them.
Common side effects These common side effects happen in around 1 in 10 people. Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or don't go away: headaches feeling or being sick nausea or vomiting being sensitive to sunlight Serious side effects are rare and happen in less than 1 in 1,000 people.
In rare cases, doxycycline can cause a serious allergic reaction anaphylaxis. These are not all the side effects of doxycycline.
For a full list see the leaflet inside your medicines packet. ASHA Mg guidelines To avoid the selection of macrolide resistance, treat urethritis, cervicitis and proctitis with one week of doxycycline 100 mg bd, instead of azithromycin.
All patients with these syndromes should be tested for MG and recalled if positive. Other MG-infected patients eg sexual partners should also pre-treated with doxycycline which lowers the bacterial load,1 increasing the likelihood of cure with a second antibiotic.
We recommend discussing this with patients.