{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:30:44Z","timestamp":1780410644949,"version":"3.54.1"},"reference-count":20,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2013,9,15]]},"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Doxycycline, one of two recommended therapies for non-gonococcal urethritis (NGU), consists of a 7-day course of therapy (100\u2005mg BID). Since suboptimal adherence may contribute to poor treatment outcomes, we examined the association between self-reported imperfect adherence to doxycycline and clinical and microbiologic failure among men with NGU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Men aged \u226516\u2005years with NGU attending a Seattle, WA, sexually transmitted diseases clinic were enrolled in a double-blind, parallel-group superiority trial from January 2007 to July 2011. Men were randomised to active doxycycline\/placebo azithromycin or placebo doxycycline\/active azithromycin. Imperfect adherence was defined as missing \u22651 dose in 7\u2005days. Urine was tested for<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT),<jats:italic>Mycoplasma genitalium<\/jats:italic>(MG), and<jats:italic>Ureaplasma urealyticum<\/jats:italic>-biovar 2 (UU-2) using nucleic acid amplification tests. Clinical failure (symptoms and \u22655\u2005PMNs\/HPF or discharge) and microbiologic failure (positive tests for CT, MG, and\/or UU-2) were determined after 3 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>184 men with NGU were randomised to active doxycycline and provided data on adherence. Baseline prevalence of CT, MG and UU-2 was 26%, 13% and 27%, respectively. 28% of men reported imperfect adherence, and this was associated with microbiologic failure among men with CT (aRR=9.33; 95% CI 1.00 to 89.2) and UU-2 (aRR=3.08; 95% CI 1.31 to 7.26) but not MG. Imperfect adherence was not significantly associated with clinical failure overall or for any specific pathogens, but it was more common among imperfectly adherent men with CT (aRR=2.63; 0.93\u20137.41, p=0.07).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adherence may be important for microbiologic cure of select pathogens. Factors other than adherence should be considered for CT-negative men with persistent NGU.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2013-051174","type":"journal-article","created":{"date-parts":[[2013,10,9]],"date-time":"2013-10-09T05:03:45Z","timestamp":1381295025000},"page":"3-7","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Suboptimal adherence to doxycycline and treatment outcomes among men with non-gonococcal urethritis: a prospective cohort study"],"prefix":"10.1136","volume":"90","clinical-trial-number":[{"clinical-trial-number":"nct00358462","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Christine M","family":"Khosropour","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa E","family":"Manhart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny V","family":"Colombara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine W","family":"Gillespie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Sylvan","family":"Lowens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A","family":"Totten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R","family":"Golden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Simoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,10,8]]},"reference":[{"issue":"(RR-12)","key":"2024051410214747000_90.1.3.1","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines, 2010","volume":"59","author":"Centers for Disease Control and Prevention","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2024051410214747000_90.1.3.2","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200209000-00001"},{"key":"2024051410214747000_90.1.3.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530070043027"},{"key":"2024051410214747000_90.1.3.4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq074"},{"key":"2024051410214747000_90.1.3.5","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis1022"},{"key":"2024051410214747000_90.1.3.6","doi-asserted-by":"publisher","DOI":"10.1086\/599033"},{"key":"2024051410214747000_90.1.3.7","doi-asserted-by":"publisher","DOI":"10.1136\/sti.79.4.318"},{"key":"2024051410214747000_90.1.3.8","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199101000-00008"},{"key":"2024051410214747000_90.1.3.9","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199211000-00011"},{"key":"2024051410214747000_90.1.3.10","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199801000-00001"},{"key":"2024051410214747000_90.1.3.11","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199905000-00006"},{"key":"2024051410214747000_90.1.3.12","doi-asserted-by":"publisher","DOI":"10.1097\/01.OLQ.0000078821.27933.88"},{"key":"2024051410214747000_90.1.3.13","unstructured":"Kenny GE. Mycoplasmata. In: Lenette E, Balows A, Hausler WJ, et al. eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 1980:365\u201370."},{"key":"2024051410214747000_90.1.3.14","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.040394"},{"key":"2024051410214747000_90.1.3.15","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-134-10-200105150-00011"},{"key":"2024051410214747000_90.1.3.16","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-006-9078-6"},{"key":"2024051410214747000_90.1.3.17","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1097\/00126334-200104150-00005","article-title":"Provider assessment of adherence to HIV antiretroviral therapy","volume":"26","author":"Bangsberg","year":"2001","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024051410214747000_90.1.3.18","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"2024051410214747000_90.1.3.19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050100"},{"key":"2024051410214747000_90.1.3.20","unstructured":"Centers for Disease Control and Prevention. Guidelines for the laboratory diagnosis of gonorrhea, chlamydia and syphilis. http:\/\/www.aphl.org"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2013-051174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T17:22:05Z","timestamp":1715707325000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2013-051174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,8]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2014,1,15]]},"published-print":{"date-parts":[[2014,2]]}},"alternative-id":["10.1136\/sextrans-2013-051174"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2013-051174","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,8]]}}}