Ciprofloxacin compared with doxycycline for nongonococcal urethritis. Ineffectiveness against Chlamydia trachomatis due to relapsing infection
T. M. Hooton, M. E. Rogers, T. G. Medina, L. E. Kuwamura, C. Ewers, P. L. Roberts and W. E. Stamm
Department of Medicine, Harborview Medical Center, University of Washington School of Medicine, Seattle 98104.
We compared 7-day regimens of ciprofloxacin in dosages of 750 and 1000 mg
twice daily with doxycycline 100 mg twice daily for the treatment of
nongonococcal urethritis in 178 men enrolled in a prospective, randomized,
double-blind trial. The overall clinical response was comparable in the
three treatment groups at both 2 and 4 weeks after therapy. However, among
patients who initially had cultures positive for chlamydia, Chlamydia
trachomatis was reisolated within 4 weeks after treatment in none of 10
doxycycline-treated patients, in 11 (52%) of 21 patients treated with 750
mg of ciprofloxacin twice daily, and in six (38%) of 16 patients treated
with 1000 mg of ciprofloxacin twice daily. Each of the recurrent strains
was identical in serotype to the original infecting strain. We conclude
that ciprofloxacin in dosages as high as 2 g daily is inadequate for
treatment of chlamydial urethritis in men, often resulting in relapsing
infections.
