Hi,
Ideally, treatments for Chlamydia should have the following qualities:
be effective (with a cure rate exceeding 95%);
be easy to take (not more than twice daily);
possess a low side-effect profile;
cause minimal interference with daily lifestyle.
In a female (which is not your case), the possibility of pregnancy should be considered, as it will affect
antibiotic choice.
The first line treatment for Chlamydia is Doxycycline, which possesses more than 95% efficacy, is relatively cheap, has a twice daily dosage and an occasional missed dose does not appear to alter efficacy. The disadvantages are that it cannot be used in pregnancy and may cause gastrointestinal disturbance and photosensitization as side-effects.
Second line treatments include Erythromycin, Azithromycin, Tetracycline, and Ofloxacin.
Erythromycin, is cheap and can be used in pregnancy. Its disadvantages are its lengthy dosing (four times daily), gastrointestinal disturbance which leads to discontinuation, and a less than 95% efficacy.
Azithromycin(Zithromax by trade name) .
Advantage: once only dosing.
Disadvantages: expensive; limited data on cure rate; unknown safety in pregnancy.
Tetracycline
Advantages: cheap, more than 95% efficacy
Disadvantages: cannot be taken with milk; cannot be taken in pregnancy; lengthy dosing of 4 times daily; no data available on missed doses.
Ofloxacin
Advantages: good efficacy, more than 95%; good side-effect profile; once daily dosage.
Disadvantages: expensive; cannot be taken in pregnancy; uncertainty about efficacy when doses are missed.
Biaxin (generic name Clarithromycin) is indicated for respiratory tract infections, skin and soft tissue infections, middle ear infection, and Helicobacter pylori eradication.
The manufacturer does not list Chlamydia as an indication for the use of the drug, and I have no experience in its use for Chlamydia. Was it prescribed by a genitourinary physician (or venereologist) for you? I have used the first three drugs for Chlamydial urethritis and cervicitis with good effect but my first choice has always been Doxycycline in males and non-pregnant females.
I hope I have answered your question.
Thank you for contacting our website.
Dr Anthony Solomon
MB BS DTM&H DIP.VEN FRSM
Consultant Physician, Tropical & Genitourinary Medicine
