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Antibiotics 2014, 3(2), 109-120; doi:10.3390/antibiotics3020109
Article

Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis

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1 Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan 2 Department of Urology, the Jikei University Katsushika Medical Center, 6-41-2 Aoto Katsushika-ku, Tokyo 1258506, Japan 3 iClinic, 5-9-6, Nagamachi, Taihaku-ku, Sendai, Miyagi 9820011, Japan 4 Iwasawa Clinic, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0600061, Japan 5 Teine Urologic Clinic, 1-12, Maeda 6-7, Teine-ku, Sapporo 0060816, Japan 6 Hosobe Clinic, 1-1-15, Nezu, Bunkyo-ku, Tokyo 1130031, Japan 7 Department of Urology, Fuji City General Hospital, 50 Takashima-Cho, Fuji, Shizuoka 4178567, Japan
* Author to whom correspondence should be addressed.
Received: 10 February 2014 / Revised: 26 February 2014 / Accepted: 4 March 2014 / Published: 2 April 2014
(This article belongs to the Special Issue Antibiotics and Urinary Tract Infections)
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Abstract

To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011–2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33). The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43) and 37.2% (16/43), respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50). The microbiological eradication rates for the pathogens were 90.9% (30/33) for Neisseria gonorrhoeae, 91.5% (43/47) for Chlamydia trachomatis, 71.4% (5/7) for Mycoplasma genitalium, and 100% (13/13) for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120). The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.
Keywords: azithromycin; extended release; urethritis; Neisseria gonorrhoeae; Chlamydia trachomatis; Mycoplasma genitalium; Ureaplasma urealyticum azithromycin; extended release; urethritis; Neisseria gonorrhoeae; Chlamydia trachomatis; Mycoplasma genitalium; Ureaplasma urealyticum
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).
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Takahashi, S.; Kiyota, H.; Ito, S.; Iwasawa, A.; Hiyama, Y.; Uehara, T.; Ichihara, K.; Hashimoto, J.; Masumori, N.; Sunaoshi, K.; Takeda, K.; Suzuki, N.; Hosobe, T.; Goto, H.; Suzuki, H.; Onodera, S. Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis. Antibiotics 2014, 3, 109-120.

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