{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:34:33Z","timestamp":1790854473720,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Taipei Municipal Wan Fang Hospital, Taipei Medical University","award":["109-wf-eva-19"],"award-info":[{"award-number":["109-wf-eva-19"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chlamydia trachomatis infection is the most common sexually transmitted infectious disease and carries a risk of complications. However, the optimal treatment for rectal chlamydial infection remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the efficacy of doxycycline and azithromycin for the treatment of rectal chlamydia by undertaking a systematic review and meta-analysis of published data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, EMBASE, Cochrane Library, Web of Science and clinicaltrials.gov databases from inception to 7 July 2021 for randomized controlled trials (RCTs) and observational studies that compared the efficacy of doxycycline and single-dose azithromycin on rectal chlamydia cure rates. Data were synthesized using a random-effects model, and subgroup analysis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All included studies were conducted in developed countries. Two RCTs and nine observational studies, with a total of 2457 patients, were analysed. Doxycycline had a higher microbiological cure rate than azithromycin (risk ratio\u2009=\u20091.21; 95% CI\u2009=\u20091.15\u20131.28; P\u2009&amp;lt;\u20090.05). Pooled results from two RCTs also revealed a higher microbiological cure rate for doxycycline than azithromycin (risk ratio\u2009=\u20091.27; 95% CI\u2009=\u20091.20\u20131.35; P\u2009&amp;lt;\u20090.05). The results remained consistent in subgroups of different study designs, countries and sexes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>On the basis of our findings, we recommend doxycycline rather than azithromycin as a first-line treatment for rectal chlamydia in developed countries. More RCTs from developing countries are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkab335","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T11:16:51Z","timestamp":1631099811000},"page":"3103-3110","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy of doxycycline versus azithromycin for the treatment of rectal chlamydia: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1052-6156","authenticated-orcid":false,"given":"Liang-Fu","family":"Chen","sequence":"first","affiliation":[{"name":"Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Lun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Chang","family":"Hsu","sequence":"additional","affiliation":[{"name":"Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Wang","family":"Hsu","sequence":"additional","affiliation":[{"name":"Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chyi-Huey","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Pin","family":"Hsu","sequence":"additional","affiliation":[{"name":"Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"},{"name":"Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, 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