{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:53:48Z","timestamp":1790380428647,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T00:00:00Z","timestamp":1548633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organization for Health Research and Development","doi-asserted-by":"crossref","award":["50-53000-98-109"],"award-info":[{"award-number":["50-53000-98-109"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,13]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rectal infections with Chlamydia trachomatis (CT) are prevalent in women visiting a sexually transmitted infection outpatient clinic, but it remains unclear what the most effective treatment is. We assessed the effectiveness of doxycycline and azithromycin for the treatment of rectal and vaginal chlamydia in women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study is part of a prospective multicenter cohort study (FemCure). Treatment consisted of doxycycline (100 mg twice daily for 7 days) in rectal CT\u2013positive women, and of azithromycin (1 g single dose) in vaginally positive women who were rectally untested or rectally negative. Participants self-collected rectal and vaginal samples at enrollment (treatment time-point) and during 4 weeks of follow-up. The endpoint was microbiological cure by a negative nucleic acid amplification test at 4 weeks. Differences between cure proportions and 95% confidence intervals (CIs) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analyzed 416 patients, of whom 319 had both rectal and vaginal chlamydia at enrollment, 22 had rectal chlamydia only, and 75 had vaginal chlamydia only. In 341 rectal infections, microbiological cure in azithromycin-treated women was 78.5% (95% CI, 72.6%\u201383.7%; n = 164\/209) and 95.5% (95% CI, 91.0%\u201398.2%; n = 126\/132) in doxycycline-treated women (difference, 17.0% [95% CI, 9.6%\u201324.7%]; P &amp;lt; .001). In 394 vaginal infections, cure was 93.5% (95% CI, 90.1%\u201396.1%; n = 246\/263) in azithromycin-treated women and 95.4% (95% CI, 90.9%\u201398.2%; n = 125\/131) in doxycycline-treated women (difference, 1.9% [95% CI, \u20133.6% to 6.7%]; P = .504).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The effectiveness of doxycycline is high and exceeds that of azithromycin for the treatment of rectal CT infections in women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trials Registration<\/jats:title><jats:p>NCT02694497.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciz050","type":"journal-article","created":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T12:09:29Z","timestamp":1547726969000},"page":"1946-1954","source":"Crossref","is-referenced-by-count":58,"title":["Treatment Effectiveness of Azithromycin and Doxycycline in Uncomplicated Rectal and Vaginal Chlamydia trachomatis Infections in Women: A Multicenter Observational Study (FemCure)"],"prefix":"10.1093","volume":"69","author":[{"given":"Nicole H T M","family":"Dukers-Muijrers","sequence":"first","affiliation":[{"name":"Department of Sexual Health, Infectious Diseases, and Environmental Health, Heerlen, South Limburg Public Health Service, The Netherlands"},{"name":"Department of Medical Microbiology, Care and Public Health Research Institute, Maastricht University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra F G","family":"Wolffs","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Care and Public Health Research Institute, Maastricht University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"De Vries","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, The Netherlands"},{"name":"Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center, The Netherlands"},{"name":"National Institute of Public Health and the Environment, Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, Bilthoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannelore M","family":"G\u00f6tz","sequence":"additional","affiliation":[{"name":"National Institute of Public Health and the Environment, Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, Bilthoven, The Netherlands"},{"name":"Department Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, The Netherlands"},{"name":"Department of Public Health, Erasmus Medical Center\u2013University Medical Center Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Titia","family":"Heijman","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Bruisten","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, The Netherlands"},{"name":"Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisanne","family":"Eppings","sequence":"additional","affiliation":[{"name":"Department of Sexual Health, Infectious Diseases, and Environmental Health, Heerlen, South Limburg Public Health Service, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjan","family":"Hogewoning","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, The Netherlands"},{"name":"Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mieke","family":"Steenbakkers","sequence":"additional","affiliation":[{"name":"Department of Sexual Health, Infectious Diseases, and Environmental Health, Heerlen, South Limburg Public Health Service, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayk","family":"Lucchesi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Care and Public Health Research Institute, Maastricht University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten F","family":"Schim van der Loeff","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, The Netherlands"},{"name":"Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J P A","family":"Hoebe","sequence":"additional","affiliation":[{"name":"Department of Sexual Health, Infectious Diseases, and Environmental Health, Heerlen, South Limburg Public Health Service, The Netherlands"},{"name":"Department of Medical Microbiology, Care and Public Health Research Institute, Maastricht University Medical Center, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,1,28]]},"reference":[{"key":"2020020405125769100_CIT0001","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.1016\/S1473-3099(17)30310-9","article-title":"Sexually transmitted infections: challenges ahead","volume":"17","author":"Unemo","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2020020405125769100_CIT0002","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1093\/jac\/dku493","article-title":"Treatment of rectal chlamydia infection may be more complicated than we originally thought","volume":"70","author":"Hocking","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"2020020405125769100_CIT0003","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/OLQ.0000000000000754","article-title":"Prevalence of rectal chlamydial and gonococcal infections: a systematic review","volume":"45","author":"Dewart","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2020020405125769100_CIT0004","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1186\/s12879-015-1280-6","article-title":"What is needed to guide testing for anorectal and pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae in women and men? 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