Single-dose cefixime 800 mg plus doxycycline 100 mg b.i.d. for 7 days compared to single-dose ceftriaxone 1 g plus single-dose azithromycin 2 g for treatment of urogenital, rectal and pharyngeal gonorrhoea: A randomised clinical trial

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Bížová, B.Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic (author)

Single-dose cefixime 800 mg plus doxycycline 100 mg b.i.d. for 7 days compared to single-dose ceftriaxone 1 g plus single-dose azithromycin 2 g for treatment of urogenital, rectal and pharyngeal gonorrhoea : A randomised clinical trial

Article/chapterEnglish2024

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European Society of Clinical Microbiology and Infectious Diseases (ESCMID),2024
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LIBRIS-ID:oai:DiVA.org:oru-109807
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-109807URI
https://doi.org/10.1016/j.cmi.2023.11.006DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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OBJECTIVES: To evaluate the efficacy and tolerability of single-dose oral cefixime 800 mg plus oral doxycycline 100 mg b.i.d. for 7 days, compared to recommended single-dose ceftriaxone plus single-dose, oral azithromycin, for treatment of uncomplicated urogenital, rectal or pharyngeal gonorrhoea.METHODS: A non-inferiority, open-label, multicentre randomised controlled trial was conducted in Prague, Czech Republic. Some 161 patients, 18-65 years of age diagnosed with uncomplicated urogenital, rectal or pharyngeal gonorrhoea by nucleic acid amplification test (NAAT) were randomised to treatment with single-dose cefixime 800 mg plus doxycycline 100 mg b.i.d. for 1 week or single-dose ceftriaxone 1 g intramuscularly plus single-dose azithromycin 2 g. The primary outcome was the number of participants with negative culture and NAAT at 1 week and 3 weeks, respectively, after treatment initiation.RESULTS: In all, 161 patients were randomised, 152 were included in per-protocol analyses. All 76 (100%; 95% confidence interval [CI], 0.95-1.00) patients treated with ceftriaxone plus azithromycin achieved negative cultures and NAAT after treatment. In the cefixime plus doxycycline arm at week 1, culture was negative in all 76 (100%) patients; at week 3, culture was negative in 70/76 patients (92%; 95%CI, 0.84-0.97) and NAAT negative in 66/76 patients (87%; 95%CI, 0.77-0.94). At week 3, culture and NAAT were negative in 65/76 patients (86%; 95%CI, 0.76-0.93). Per-protocol risk difference was 14.5% (95%CI, 6.56-22.38). All treatment failures observed in the cefixime arm were pharyngeal gonorrhoea cases.CONCLUSION: The combination of cefixime and doxycycline did not achieve non-inferiority to ceftriaxone and azithromycin for treatment of gonorrhoea when including pharyngeal gonorrhoea. It did, however, show high efficacy for urogenital and rectal gonorrhoea.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Infektionsmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Infectious Medicine hsv//eng
Azithromycin
Cefixime
Ceftriaxone
Doxycycline
Neisseria gonorrhoeae
Treatment

Added entries (persons, corporate bodies, meetings, titles ...)

Procházka, P.Venereology Prague, Medicentrum Beroun, Prague, Czech Republic (author)
Nyčová, E.Department of Microbiology, University Hospital Bulovka, Prague, Czech Republic (author)
Bořil, P.Clinical Laboratory, Medicentrum Beroun, Beroun, Czech Republic (author)
Kubele, J.Clinical Microbiology and ATB centre, Na Homolce Hospital, Prague, Czech Republic (author)
Poláková, A.Department of Microbiology, University Hospital Bulovka, Prague, Czech Republic (author)
Zemanová, Z.Clinical Microbiology and ATB centre, Na Homolce Hospital, Prague, Czech Republic (author)
Unemo, Magnus,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,World Health Organization Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Microbiology, Faculty of Medicine of Health, Örebro University, Örebro, Sweden; Institute for Global Health, University College London, London, United Kingdom(Swepub:oru)muo (author)
Rob, F.Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic (author)
Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech RepublicVenereology Prague, Medicentrum Beroun, Prague, Czech Republic (creator_code:org_t)

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In:Clinical Microbiology and Infection: European Society of Clinical Microbiology and Infectious Diseases (ESCMID)30:2, s. 211-2151198-743X1469-0691

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