The world Health Organization estimates the annual incidence of chlamydia in the world 100 million variable Prevalence in different countries: in developing ten times higher. Russia recorded more than 100 cases per 100 thousand population annually, accounting for 20% of all detected sexually transmitted infections.
Chlamydia is classified as bacteria, they contain DNA and RNA. These microorganisms capable of long-term persist in the host cell, and are completely dependent on its energy resources. Universal 2-phase life cycle allows the pathogen to adapt to the intracellular and extracellular form of existence
The incubation period — from 7 to 21 days.
In 40% of cases in women and 20% in men, chlamydia is diagnosed in conjunction with gonorrhea, which should be considered when selecting treatment regimens.
Antibiotics trichomoniasis: treatment regimens for men and women
The CDC (Center for control and prevention of diseases USA) recommends Azithromycin and Doxycycline as drugs of choice for treatment of chlamydial infection, and an efficiency of 95%.
It is important
There is confirmed evidence that Azithromycin causes a failure of the heart rhythm that you need to pay attention to. For patients with abnormalities of the QT-interval or receiving the drugs over arrhythmia, it is preferable to use Doxycycline.
For several decades for the treatment of chlamydia used Doxycycline 0.1 g 2 R/d orally, for 7 days.
Studies have shown that Azithromycin, taken in a dose of 1 mg once, more effective than weekly intake of Doxycycline.
Rifampicin, which is highly active against chlamydia, trachomatis, and has a long half-life, is sometimes applied as a single dose for the treatment of chlamydial urethritis negonokokkovi etiology. Currently, it can be recommended to receive women with uncomplicated genital infection.
After the therapy the second study on chlamydia is not required but is recommended after 3 months to exclude using tests reinfection.
Azithromycin is the drug of choice as it is active against several sexually transmitted infections at the same time:
Ofloxacin 200 mg 2 R/d for 7 days, Levofloxacin 500 mg once daily for 7 days, are considered as alternative treatment options.
For chlamydia, complicated by an inflammatory process in pelvic organs, prescribe cephalosporins with 2-week course of Doxycycline, or use the scheme:
Clindamycin plus Gentamicin; Ampicillin-sulbactam plus Doxycycline.
Ambulatornoe treatment is based on the following schemes:
Cephalosporins second-or third-generation in the initial single dose in combination with Doxycycline for 14 days with or without Metronidazole 500 mg twice daily course of 14 days.
Because of the emergence of resistance to fluoroquinolones Neisseria gonorrhoeae Nasser, the latter is not recommended.
Chlamydial conjunctivitis and pneumonia is usually treated with prescription of antibacterial drugs within 14 days.
It is important
Treatment is also indicated for all sexual partners. Holding protivodiareynoe therapy and patients undergoing treatment of gonorrhea.
Who recommendations for treatment of chlamydia
Who recommendations for the treatment of uncomplicated genital chlamydia the following:
- Azithromycin 1 g orally once, or Doxycycline 100 mg orally twice a day for 7 days.
- alternative scheme: Tetracycline 500 mg orally 4 times a day for 7 days, or Erythromycin 500 mg orally twice a day for 7 days, or Ofloxacin 200-400 mg orally twice a day for 7 dnaa
For the treatment of anorectal chlamydial infection the who recommends Doxycycline 100 mg orally twice a day for 7 days or Azithromycin 1 g orally once.
Randomized trials have shown that parenteral and oral schemes have similar clinical efficacy in moderate forms.
Treatment of chlamydia in pregnant women
- Azithromycin 1 g once;
- Josamycin, 500-1000 mg 2 R/d — 7 days;
- Amoxicillin 500 mg 4./D. — 7 days.
European and Russian recommendations for treatment of chlamydia during the period of gestation considering Josamycin as an effective and safe drug in pregnant women.
Who recommendations for treatment of chlamydia during pregnancy is the following:
- Azithromycin 1 g orally once.
- Amoxicillin 500 mg orally 3 times a day for 7 days;
- Erythromycin 500 mg orally twice a day for 7 days.
Lymphogranuloma venereum: treatment
Who recommendations for the treatment of venereal lymphogranuloma:
- In adults and adolescents with sexually transmitted lymphogranuloma in the guideline offer Doxycycline 100 mg orally twice a day for 21 days, Azithromycin 1 g orally weekly for 3 weeks.
- Intolerance Doxycycline drug substitute for Azithromycin.
- Alternative scheme: Erythromycin 500 mg orally 4 times a day for 21 days.
Doxycycline should not be used in pregnant women.
Victoria Mishina, urologist, medical columnist