lymecycline and Chlamydia-Infections

Topics: Anti-Bacterial Agents; Chlamydia Infections; Cost-Benefit Analysis; Drug Costs; Humans; Lymecycline; Male; Sweden; Tetracycline; Urethritis

To compare the clinical and microbiological efficacy of azithromycin in curing chlamydial infections in women with that of lymecycline, and with a view of the possibility of minimizing the problem of compliance by means of single-dose administration, 146 women with culture-positive Chlamydia trachomatis infections were randomly assigned to treatment with a 1 g bolus dose of azithromycin or a 10-day course of lymecycline 300 mg twice daily. Clinical and microbiological evaluations were performed and adverse effects monitored at check-ups after 15-35 and 40-65 days. Of the 146 patients enrolled in the study, 120 were evaluable. At the second check-up, C. trachomatis was found to have been eradicated in all patients in both treatment groups. Of the 51 patients who had clinical signs and symptoms of genital infection at enrolment, 96% (22/23) of those in the azithromycin group were considered cured (n = 18) or improved (n = 4), as compared with 100% (28/28) of those considered cured (n = 22) or improved (n = 6) in the lymecycline group. Adverse events related, or possibly related, to treatment were reported by 16 (21.6%) of the lymecycline group, but by only 6 (8.3%) of the azithromycin group. The 2 drugs were comparable with regard to microbiological and clinical efficacy in the treatment of genital chlamydial infection in women. The markedly lower rate of side-effects associated with azithromycin may be a feature conducive to patient compliance.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Double-Blind Method; Female; Genital Diseases, Female; Humans; Lymecycline; Recurrence; Safety; Treatment Outcome

We conducted a double-blind, placebo-controlled, randomized study of 3-month treatment with lymecycline, a form of tetracycline, in reactive arthritis (ReA). Lymecycline therapy significantly decreased the duration of the illness in patients with Chlamydia trachomatis-triggered ReA, but not in other ReA patients. In 2 ReA patients, C trachomatis was found in the throat, an uncommon locale for this organism. Our results suggest that it is important to verify the triggering microbe and that it is beneficial to treat Chlamydia arthritis patients with a prolonged course of tetracycline.

Topics: Adult; Antibodies, Bacterial; Arthritis, Infectious; Chlamydia Infections; Chlamydia trachomatis; Double-Blind Method; Feces; Humans; Lymecycline; Male; Prohibitins; Sulfasalazine; Time Factors; Yersinia

In a clinical, controlled trial 55 women with a history of pelvic inflammatory disease (PID) undergoing first-trimester abortion were randomized to either lymecycline therapy or placebo. Twenty-four women received lymecycline capsules 300 mg b.i.d. for 14 days starting on the morning of the abortion and 31 received similar placebo medication. In the lymecycline group 2 women (8.3%) and in the placebo group 7 (22.6%) contracted postabortal PID, a non-significant difference (p greater than 0.2). The variables age, gestational age, number of spontaneous abortions, births and episodes of PID, and Hegar size were not associated with the rate of postabortal PID. Women without previous induced abortions had a significantly increased rate of postabortal infection (p = 0.02), but the treatment did not influence this rate. Three women had a positive culture for Chlamydia trachomatis at the time of abortion and two of these had postabortal PID. None of 7 women with postabortal PID had significant increases in IgA, IgG or IgM chlamydia antibody titers, but two women with uncomplicated abortions had serological evidence of infection. The number of hospital days and amounts of antibiotics prescribed to women with postabortal PID were not significantly different between the two treatment groups (p greater than 0.05). Women with a history of PID had an elevated risk of postabortal PID warranting the use of some sort of prophylaxis, and screening for C. trachomatis in an abortion population is recommended.. To assess the efficacy of prophylactic antibiotics on postabortal infection in women with a history of pelvic inflammatory diseases (PID), 55 such women undergoing 1st-trimester pregnancy termination were randomly assigned to receive either lymecycline therapy or placebo. Chlamydial antibodies were investigated in all women before and after the abortion. 24 women received 300 mg lymecycline capsules for 14 days, starting on the morning of the abortion procedure; the remaining 31 women received placebo medication on the same schedule. Postabortal PID occurred in 2 women (8.3%) in the lymecycline group and 7 women (22.6%) in the placebo group--a nonsignificant difference. Age, gestational age, number of spontaneous abortions, births, previous episodes of PID, Hegar size, and the presence of C trachomatis did not influence the rate of postabortal PID. Although women with no previous abortions had a significantly higher rate of infection, this rate was not influenced by the preabortion treatment mode. C trachomatis was identified in 3 of 53 women for whom cultures were obtained; 2 of these women contracted postabortal PID. None of the 7 women with postabortal PID had significant increases in IgA, IgG, or IgM chlamydia antibody titers, although 2 women with uncomplicated abortions had serologic evidence of infection. Use of lymecycline did not significantly reduce the number of hospital days or amounts of antibiotics required among women with postabortal PID. Overall, the high rate of postabortal PID recorded in this study among women with a history of PID (23%) supports the use of some sort of prophylactic method. Since these women do not seem to harbor chlamydial infection more often than women without previous PID, penicillin or ampicillin may be effective.

Topics: Abortion, Induced; Adult; Antibodies, Bacterial; Chlamydia; Chlamydia Infections; Clinical Trials as Topic; Female; Humans; Lymecycline; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Trimester, First; Tetracyclines

Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum infections not only jeopardize fertility but also pose a risk for infertility treatment and resulting pregnancies. Routine screening tests or empirical antibiotic treatment of infertile couples may be justified by the prevalence of these organisms. We studied the wives in 40 consecutive infertile couples. Monoclonal direct immunofluorescence (DIF) for C trachomatis was performed on fixed smears from endocervical swabs. M hominis and U urealyticum were isolated by inoculation of Hayflick (HF) medium, HF broth and Ureaplasma A7 agar with endocervical swabs. Using DIF, 11 (27.5%) specimens were positive, 25 (62.5%) were negative, and 4 (10.0%) were equivocal. DIF was repeated on smears from three of the last four patients; all three were positive for C trachomatis. One patient was lost to follow-up and excluded from the study. For the total 39 specimens the final results were 14 (35.9%) positive and 25 (64.1%) negative. M hominis was isolated from 3 (7.5%) endocervical swabs. None of the endocervical swabs yielded a culture positive for U urealyticum. Statistical analysis showed no correlation between the clinical history and presence of infection with any of the three organisms. The prevalence of 35.9% for C trachomatis was surprisingly high for an infertile population and, if supported by culture confirmation, justifies routine screening. The potential adverse effects of these organisms on the success rate of highly specialized infertility treatments are essentially unresolved. Since our analysis of cost effectiveness as applicable to our unit, all new infertile couples are treated empirically with lymecycline.

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Female; Humans; Infertility, Female; Lymecycline; Mycoplasma Infections; Mycoplasmatales Infections; Pregnancy; Prevalence; South Africa; Ureaplasma

In a study at the University Hospital in Trondheim during 1983, the frequency of Chlamydia trachomatis among women terminating their pregnancies was 8.2%. Younger women were infected by C. trachomatis at a more frequent rate than older women (p less than 0.001). Treatment of chlamydia-positive women was initiated within the first two weeks after the abortion. However, among women readmitted to the hospital, chlamydia-positive women showed a higher frequency of salpingitis than chlamydia-negative women (p less than 0.08). Preabortion examination for C. trachomatis and treatment of chlamydia-positive women by practitioners before the abortion is carried out, may reduce the postabortal frequency of salpingitis.. A study was conducted at the University Hospital in Trondheim, Norway, in 1983 to investigate the routines for sampling of "C. trachomatis" and treatment of chlamydia-positive women in relation to abortion during the 1st trimester. 823 abortions were performed during the 1st trimester in 1983. The patients were examined the day prior to the operation and specimens for "C. trachomatis" and "N. gonorrhea" were collected from the cervix uteri. 769 women were included in the final analysis. The number of women infected with "C. trachomatis" at the time of abortion was 60 (8.2%). This did not include 37 cultures which were inconclusive due to nonspecific cytopathogenic effects. The highest frequencies were found in the younger age groups. After age standardization, nulliparous women (9.8%) had a higher infection rate than women (5.0%) with 1 or more previous pregnancies. The prevalence of "N. gonorrhea" was 0.6%. 2 women were positive for both "C. trachomatis" and "N. gonorrhea." Of 37 patients who were readmitted to the hospital, 6 were chlamydia-positive and 30 chlamydia-negative, representing 10% and 4.5%, respectively. 1 patient, who was readmitted, had inconclusive chlamydia culture. Postabortal salpingitis was confirmed at readmission among 5% of the chlamydia-positive women; 1.2% of the chlamydia-negative women were treated in the hospital for salpingitis.

Topics: Abortion, Induced; Adult; Cervix Uteri; Chlamydia Infections; Chlamydia trachomatis; Drug Therapy, Combination; Female; Humans; Lymecycline; Metronidazole; Norway; Postoperative Complications; Pregnancy; Salpingitis

The treatment of chlamydial urethritis in males depends on the susceptibility of Chlamydia trachomatis to different antimicrobial agents. Tetracyclines seem to be the drugs of choice; long-acting tetracyclines are recommended, as these are more convenient for the patient. Both lymecycline and doxycycline produce clinical and bacteriological cure in approximately 90% of cases, when used in adequate doses. Erythromycin is the alternative treatment in patients who should not be given tetracyclines. Trimethoprim/sulfamethoxazole is effective in patients with chlamydial urethritis, but it seems to be ineffective in those with Chlamydia-negative urethritis. The importance of treating sexual partners should not be overlooked.

Topics: Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Doxycycline; Erythromycin; Genital Diseases, Male; Humans; Lymecycline; Male; Tetracyclines; Urethritis

Chlamydia trachomatis was isolated from the urethra in 71 of 275 men primarily attending the outpatient clinic of the Department of Urology because of symptoms of acute urethritis, and with more than four polymorphonuclear leukocytes in each of at least five fields of the swabbed urethral exudate (x1000). C. trachomatis was isolated from 34 of 48 men below 26 years of age, while only 37 of the 227 men aged 26 years or older harboured chlamydial infection. C. trachomatis was isolated from the prostatic secretion of 26 men with acute urethritis and more than 20 polymorphonuclear leukocytes in 10 or more random fields (x450) in the stripped prostatic fluid, suggesting a positive correlation between chlamydial infection and sub-acute silent prostatitis. Among 70 men with C. trachomatis isolated from the urethra, the organism had disappeared at re-examination within 10 days in 19 (27%). Such a disappearance was found in only one of 26 men (4%) in whom C. trachomatis had been isolated not only from the urethra but also from stripped prostatic fluid. Four weeks after two treatment cycles of lymecycline 300 mg twice daily for 7 days with an interval of 10 days, C. trachomatis was but isolated in any urethral specimen, nor from the expressed prostatic fluid.

Topics: Adolescent; Adult; Body Fluids; Chlamydia Infections; Chlamydia trachomatis; Humans; Lymecycline; Male; Middle Aged; Prostate; Prostatitis; Urethra; Urethritis

A group of 213 men with non-gonococcal urethritis and their sexual partners were treated either with erythromycin stearate 500 mgx2 for 15 days or with lymecycline 300 mgx2 for 10 or 20 days. Chlamydia trachomatis was isolated from 40% of the men, from 26% of their female partners and from 56% of the partners of men with chlamydia-positive urethritis. One hundred and eighty-one men were available for evaluation of therapy. There were no significant differences between the treatment schedules. The cure rate was 86-90% in men with chlamydia-positive and 89-100% in men with chlamydia-negative urethritis. Four of the 17 chlamydia-positive females treated with erythromycin and 2 of the 20 chlamydia-positive females treated with lymecycline for 10 days still had chlamydia at re-examination.

Topics: Chlamydia Infections; Drug Evaluation; Erythromycin; Female; Humans; Lymecycline; Male; Tetracyclines; Time Factors; Urethritis