A randomized trial to compare 7- and 21-day tetracycline regimens in the prevention of recurrence of infection with Chlamydia trachomatis

Article Abstract:

In developed nations, the most common sexually transmitted disease is infection with Chlamydia trachomatis. In the United States, the standard therapy for chlamydia infections involves a seven-day treatment period with tetracycline, erythromycin, or doxycycline. However, some cases require a longer treatment period, up to 21 days, to eliminate the infection. After the treatment period has ended, the patient is retested to make sure that the infection has been cured. This procedure is called a test-of-cure (TOC). But recurrent infections with the same strain of Chlamydia trachomatis, following seven days of treatment and TOC, are not uncommon, and may indicate that the standard therapy time should be increased. In an attempt to evaluate the relationship between the duration of treatment and the rate of recurrence of infection, the medical records of 2,983 patients, who were treated with the standard therapy for chlamydia infection, were reviewed. During a two-year follow-up period, the rate of recurrence of infection was 29 percent. Recurrence of infection was associated with young age, but not with gender or race. To determine if a longer treatment period could reduce the rate of recurrence of infection, 220 patients with chlamydia were treated with tetracycline for either 7 or 21 days. Among patients who returned, the recurrence rate was 14 percent for the seven-day treatment and 18 percent for the 21-day treatment. The difference in the recurrence rate between the two treatment groups was not statistically significant. It is concluded that a 21-day treatment period is no more effective than a seven-day treatment period in preventing recurrence of chlamydia infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Chlamydia trachomatis, Tetracycline, Tetracyclines

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Declining prevalence of chlamydial infection among adolescent girls

Article Abstract:

Chlamydia infections may be decreasing within the adolescent population. In October 1985, four Indianapolis clinics serving teenaged girls began systematically identifying and counseling teenaged girls diagnosed with Chlamydia infection. Between 1985 and 1994, the percentage of adolescent girls with first-time diagnoses of Chlamydia infection fell steadily from 26% to 10%. However, a behavioral study carried out between 1985 and 1988 also found a decline in average frequency of sexual activity per month from 6.2 to 5.0, a decline in average years of lifetime sexual activity from 2.0 to 1.2, and an increase in condom use to a maximum of 25%. The control program could not have directly affected first-time diagnoses; however, it could have reduced the pool of infected persons transmitting Chlamydia in the population. Other behavioral factors also appear to have played a role in the decline in infection rates.

Health aspects, Demographic aspects, Teenage girls

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Diagnosis of mucopurulent cervicitis among women at risk for Chlamydia trachomatis infection

Article Abstract:

The effectiveness of endocervical Gram stains for diagnosing Chlamydia infections of the cervix was evaluated. The technique involves staining bacteria samples from the cervix on a slide and viewing it under a microscope. Over 200 women were tested by Gram stain, by visual examination of the cervix and by sample cultures. Although almost a quarter of the Gram stains were unacceptable because of contamination with matter from the vagina, it was concluded that Gram stains are a valuable tool in screening for chlamydial infections, particularly among women without abnormal vaginal discharge.

Sexually transmitted diseases, Diagnosis, Sexually transmitted disease diagnosis, Cervix uteri, Cervicitis

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