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Clinical Trial
. 2013 Aug 17:13:379.
doi: 10.1186/1471-2334-13-379.

A cohort study of Chlamydia trachomatis treatment failure in women: a study protocol

Jane S Hocking, Lenka A Vodstrcil, Wilhelmina M Huston, Peter Timms, Marcus Y Chen, Karen Worthington, Ruthy McIver, Sepehr N Tabrizi; Australian Chlamydia Treatment Study (ACTS) investigators
Collaborators
Clinical Trial

A cohort study of Chlamydia trachomatis treatment failure in women: a study protocol

Jane S Hocking et al. BMC Infect Dis. .

Abstract

Background: Chlamydia trachomatis is the most commonly diagnosed bacterial sexually transmitted infection in the developed world and diagnosis rates have increased dramatically over the last decade. Repeat infections of chlamydia are very common and may represent re-infection from an untreated partner or treatment failure. The aim of this cohort study is to estimate the proportion of women infected with chlamydia who experience treatment failure after treatment with 1 gram azithromycin.

Methods/design: This cohort study will follow women diagnosed with chlamydia for up to 56 days post treatment. Women will provide weekly genital specimens for further assay. The primary outcome is the proportion of women who are classified as having treatment failure 28, 42 or 56 days after recruitment. Comprehensive sexual behavior data collection and the detection of Y chromosome DNA and high discriminatory chlamydial genotyping will be used to differentiate between chlamydia re-infection and treatment failure. Azithromycin levels in high-vaginal specimens will be measured using a validated liquid chromatography-tandem mass spectrometry method to assess whether poor azithromycin absorption could be a cause of treatment failure. Chlamydia culture and minimal inhibitory concentrations will be performed to further characterize the chlamydia infections.

Discussion: Distinguishing between treatment failure and re-infection is important in order to refine treatment recommendations and focus infection control mechanisms. If a large proportion of repeat chlamydia infections are due to antibiotic treatment failure, then international recommendations on chlamydia treatment may need to be re-evaluated. If most are re-infections, then strategies to expedite partner treatment are necessary.

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Figures

Figure 1
Figure 1
Algorithm for classifying treatment failure.
Figure 2
Figure 2
Classification of study endpoint.
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References

    1. World Health Organisation. Global incidence and prevalence of selected curable sexually transmitted infections - 2008. Geneva: World Health Organisation; 2012.
    1. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2011. Atlanta: U.S: Department of Health and Human Services; 2012.
    1. Schachter J, Stephens RS. In: Sexually Transmitted Diseases. 4. Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, Cohen MS, Watts DH, editor. New York: McGraw-Hill; 2008. Biology of Chlamydia trachomatis; pp. 555–574.
    1. Peipert JF. Genital chlamydial infections. New Eng J Med. 2003;349:2424–2430. doi: 10.1056/NEJMcp030542. - DOI - PubMed
    1. Haggerty CL, Gottlieb SL, Taylor BD, Low N, Xu F, Ness RB. Risk of sequelae after chlamydia trachomatis genital infection in women. J Infect Dis. 2010;201:S134–S155. doi: 10.1086/652395. - DOI - PubMed

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