{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:44Z","timestamp":1787014364874,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T00:00:00Z","timestamp":1520294400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There are ongoing concerns about treatment failure with azithromycin for the treatment of rectal chlamydia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate treatment efficacy of two treatments for rectal chlamydial infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of all patients diagnosed with rectal chlamydial infection between 2009 and 2015 in Adelaide, Australia. Patients were treated with either azithromycin (1 g single dose) or doxycycline (100 mg twice a day for 10 days) and returned for repeat testing 14\u2013180 days after treatment commenced. Log\u2010binomial models were used to estimate the relative risk (RR) of recurrent rectal chlamydia associated with the treatment with azithromycin versus doxycycline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In men, rectal chlamydia prevalence was 6.7%, and in women, it was 8.1%. Of the 526 patients diagnosed with rectal chlamydial infections, 419 (79.7%), 93 (17.7%) and 14 (2.6%) patients were treated with doxycycline, azithromycin or other medication respectively. Of these patients, 173 (41.3%) of 419 doxycycline\u2010treated patients and 31 (33.3%) of 93 azithromycin\u2010treated patients were retested between 14 and 180 days after treatment commenced (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.16). Among these patients, the repeat rectal chlamydia test was less commonly positive in those treated with doxycycline (5.8%; 95% confidence interval (CI) 0.03\u20130.10) compared with those treated with azithromycin (19.4%; 95% CI 0.09\u20130.36) and (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01). In the multivariate analysis, azithromycin\u2010treated patients had a significantly higher risk of a positive test in the 14 and 180 days after treatment commenced (adjusted relative risk (aRR) 2.96, 95% CI 1.16\u20137.57).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings suggest that doxycycline may be more effective than azithromycin in treating rectal chlamydial infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.13624","type":"journal-article","created":{"date-parts":[[2017,10,2]],"date-time":"2017-10-02T03:46:37Z","timestamp":1506915997000},"page":"259-264","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The efficacy of azithromycin and doxycycline treatment for rectal chlamydial infection: a retrospective cohort study in South Australia"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5793-9455","authenticated-orcid":false,"given":"Bin","family":"Li","sequence":"first","affiliation":[{"name":"School of Public Health The University of Adelaide  Adelaide South Australia Australia"},{"name":"STI Services (Clinic 275), Infectious Disease Unit Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane S.","family":"Hocking","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Bi","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Bell","sequence":"additional","affiliation":[{"name":"STI Services (Clinic 275), Infectious Disease Unit Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Fairley","sequence":"additional","affiliation":[{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-113"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62035-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181a44b8c"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"e0140297","DOI":"10.1371\/journal.pone.0140297","article-title":"Prevalence of and factors associated with rectal\u2010only chlamydia and gonorrhoea in women and in men who have sex with men","volume":"10","author":"Liere GA","year":"2015","journal-title":"PLoS One"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001185"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1093\/jac\/dku574","article-title":"The efficacy of azithromycin and doxycycline for the treatment of rectal chlamydia infection: a systematic review and meta\u2010analysis","volume":"70","author":"Kong FY","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1136\/sextrans-2011-050466","article-title":"What is the appropriate treatment for the management of rectal Chlamydia trachomatis in men and women?","volume":"88","author":"Hathorn E","year":"2012","journal-title":"Sex Transm Infect"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1258\/ijsa.2011.011134","article-title":"Seven days of doxycycline is an effective treatment for asymptomatic rectal Chlamydia trachomatis infection","volume":"22","author":"Elgalib A","year":"2011","journal-title":"Int J STD AIDS"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181c3ef29"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit437"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318195bd2b"},{"key":"e_1_2_7_13_1","unstructured":"Australian Sexual Health Alliance. Australian STI management guidelines for use in primary care. ASHM;2016."},{"key":"e_1_2_7_14_1","first-page":"372","article-title":"Sexually transmitted diseases: summary of 2015 CDC treatment guidelines","volume":"56","author":"Centers for Disease Control and Prevention","year":"2015","journal-title":"J Miss State Med Assoc"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415615443"},{"key":"e_1_2_7_16_1","unstructured":"World Health Organisation. WHO guidelines for the treatment ofChlamydia trachomatis 2016."},{"key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12879-016-2125-7","article-title":"Treatment efficacy of azithromycin 1 g single dose versus doxycycline 100 mg twice daily for 7 days for the treatment of rectal chlamydia among men who have sex with men \u2013 a double\u2010blind randomised controlled trial protocol","volume":"17","author":"Lau A","year":"2017","journal-title":"BMC Infect Dis"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1030-9"},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1128\/CVI.00763-12","article-title":"Effect of HIV and chlamydia infection on rectal inflammation and cytokine concentrations in men who have sex with men","volume":"20","author":"Heiligenberg M","year":"2013","journal-title":"Clin Vaccine Immunol"},{"key":"e_1_2_7_20_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/OLQ.0000000000000088","article-title":"Comparing azithromycin and doxycycline for the treatment of rectal chlamydial infection: a retrospective cohort study","volume":"41","author":"Khosropour CM","year":"2014","journal-title":"Sex Transm Dis"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13624","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13624","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T02:54:56Z","timestamp":1695524096000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.13624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1111\/imj.13624"],"URL":"https:\/\/doi.org\/10.1111\/imj.13624","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3]]},"assertion":[{"value":"2017-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-09-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}