Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis

• Main Authors: Satoshi Takahashi (Author), Hiroshi Kiyota (Author), Shin Ito (Author), Akihiko Iwasawa (Author), Yoshiki Hiyama (Author), Teruhisa Uehara (Author), Koji Ichihara (Author), Jiro Hashimoto (Author), Naoya Masumori (Author), Kenichi Sunaoshi (Author), Koichi Takeda (Author), Nobukazu Suzuki (Author), Takahide Hosobe (Author), Hirokazu Goto (Author), Hidenori Suzuki (Author), Shoichi Onodera (Author)
• Format: Book
• Published: MDPI AG, 2014-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2079-6382; 10.3390/antibiotics3020109
• Keywords: azithromycin; extended release; urethritis; Neisseria gonorrhoeae; Chlamydia trachomatis; Mycoplasma genitalium; Ureaplasma urealyticum; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 3, Iss 2, Pp 109-120 (2014)

To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011-2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33). The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43) and 37.2% (16/43), respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50). The microbiological eradication rates for the pathogens were 90.9% (30/33) for Neisseria gonorrhoeae, 91.5% (43/47) for Chlamydia trachomatis, 71.4% (5/7) for Mycoplasma genitalium, and 100% (13/13) for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120). The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.