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J Antimicrob Chemother. 2014 Nov;69(11):3116-8. doi: 10.1093/jac/dku221. Epub 2014 Jun 19.

A single 2 g oral dose of extended-release azithromycin for treatment of gonococcal urethritis.

Author information

1
Department of Urology, Gifu University Hospital, Gifu, Japan super7@gifu-u.ac.jp.
2
iClinic, Sendai, Japan.
3
Urological Infection Study Group in West Saitama, Saitama, Japan.
4
Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan.

Abstract

OBJECTIVES:

We treated gonococcal urethritis in men with a single 2 g dose of azithromycin extended-release formulation (azithromycin-SR) to determine its microbiological outcomes and tolerability.

PATIENTS AND METHODS:

We enrolled 189 Japanese men with gonococcal urethritis between April 2009 and December 2013. The patients were given a single 2 g dose of azithromycin-SR. Microbiological efficacy was evaluated by the results of the post-treatment molecular testing of Neisseria gonorrhoeae. MIC testing was performed only for pretreatment isolates of N. gonorrhoeae collected from the patients.

RESULTS:

We evaluated 130 patients for microbiological outcomes. Of these patients, 122 (93.8%) were judged to be microbiologically cured on the basis of negative test results. All isolates for which the azithromycin MICs were ≤0.25 mg/L were eradicated, whereas 5 of 12 isolates for which the MICs were 1 mg/L persisted after the treatment. Forty-six adverse events occurred in 41 patients. However, all adverse events were classified as mild.

CONCLUSIONS:

The eradication rate of N. gonorrhoeae was 93.8% in men with gonococcal urethritis treated with a single 2 g dose of azithromycin-SR. The breakpoint MIC of a 2 g dose of azithromycin-SR for gonococcal urethritis associated with clinical treatment failures appeared to be 1 mg/L. With regard to side effects of higher doses of azithromycin, the 2 g dose of azithromycin-SR appeared to improve tolerability. However, the widespread use of a high-dose regimen of azithromycin might lead to the development of further resistance to azithromycin.

KEYWORDS:

Neisseria gonorrhoeae; azithromycin-SR; male urethritis

PMID:
24948703
DOI:
10.1093/jac/dku221
[Indexed for MEDLINE]

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