A meta-analysis 2 assessing azithromycin (1 g once) versus doxycycline (100 mg twice daily for 7 days) for genital chlamydial infections included 12 RCTs with a total of 1543 males and nonpregnant females. Cure rates were 97% for azithromycin and 98% for doxycycline. Adverse events occurred in 25% and 23% of patients treated with azithromycin and doxycycline, respectively. After pooling of the data, differences in efficacy and risk were computed. The efficacy and risk of adverse events between the two drugs were not statistically significant.
A topic in Clinical Evidence 1 summarizes the results of 22 RCTs comparing 19 different multiple dose regiments. 11 trials assessed doxycycline and yielded an average cure rate of 98% (six trials 100%). The summary cure rate for tetracycline (4 RCTs) was 97%, for erythromycin 2 g daily for 7 days (2 RCTs) 94-100%. Failure of microbiological cure was significantly more frequent with ciprofloxacin than with doxycycline (OR 5.0, 95% CI 1.2 to 10.0).
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