HealthDay News — Azithromycin is not noninferior to doxycycline for treatment of urogenital chlamydia infection among adolescents; however, the efficacy of both types of treatment is high, according to a study published in the New England Journal of Medicine.
William M. Geisler, MD, MPH, from the University of Alabama at Birmingham, and colleagues conducted a randomized trial comparing oral azithromycin with doxycycline for urogenital chlamydia infection among adolescents in youth correctional facilities. The authors assessed the noninferiority of 1 g azithromycin (one dose) with 100 mg doxycycline twice daily for seven days. Participants were randomly allocated to receive azithromycin (284 participants) or doxycycline (283 participants). The per-protocol population comprised 155 patients in each treatment group.
The researchers found that treatment failure did not occur in any patients in the doxycycline group, compared with five patients (3.2%) in the azithromycin group. The observed difference in treatment failure was 3.2%, with an upper boundary of the 90% confidence internal of 5.9%; this exceeded the prespecified absolute 5% cut-off for establishing noninferiority of azithromycin.
“In the context of a closed population receiving directly observed treatment for urogenital chlamydia infection, the efficacy of azithromycin was 97%, and the efficacy of doxycycline was 100%,” the authors write. “The noninferiority of azithromycin was not established in this setting.”
Geisler disclosed financial ties to ActivBiotics Pharma.