zithromax and Epididymitis

Chlamydia trachomatis is one of the major pathogens causing acute epididymitis. Azithromycin (AZM) has a good efficacy against C. trachomatis; however, the ability of AZM to penetrate into human epididymal tissue has not yet been fully elucidated. Here, we examined the appropriate dosage of oral AZM for human epididymal tissue by site-specific pharmacokinetic/pharmacodynamic (PK/PD) analysis.. Patients with prostate cancer who underwent orchiectomy were included in this study. All patients received a 1-g dose of AZM before orchiectomy. Both epididymal tissue and blood samples were collected during surgery, and the drug concentrations were measured by high-performance liquid chromatography. All concentration-time data were analyzed with a three-compartment model with first-order absorption and elimination processes to simulate AZM concentrations in serum and epididymal tissue.. A total of 10 patients were enrolled in the current study. For the observed values, the ratio of the epididymal concentration to the serum concentration was 5.13 ± 3.71 (mean ± standard deviation). For the simulated values, the maximum concentrations were 0.64 μg/mL at 2.42 h in serum and 1.96 μg/g at 4.10 h in epididymal tissue. The 24-h concentrations were 0.239 μg/mL in serum and 0.795 μg/g in epididymal tissue.. The penetration of oral AZM into human epididymal tissue was examined to assess the potential application of AZM for the treatment of acute epididymitis. Based on the previous reports mentioning drug-susceptibility of C. trachomatis, multiple doses of oral AZM 1 g would be recommended for epididymitis based on the site-specific PK/PD.

Topics: Administration, Oral; Aged; Aged, 80 and over; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Dose-Response Relationship, Drug; Drug Resistance, Bacterial; Epididymis; Epididymitis; Humans; Male; Middle Aged; Orchiectomy; Prostatic Neoplasms; Tissue Distribution

Chlamydia trachomatis is a gram-negative bacterium that infects the columnar epithelium of the cervix, urethra, and rectum, as well as nongenital sites such as the lungs and eyes. The bacterium is the cause of the most frequently reported sexually transmitted disease in the United States, which is responsible for more than 1 million infections annually. Most persons with this infection are asymptomatic. Untreated infection can result in serious complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy in women, and epididymitis and orchitis in men. Men and women can experience chlamydia-induced reactive arthritis. Treatment of uncomplicated cases should include azithromycin or doxycycline. Screening is recommended in all women younger than 25 years, in all pregnant women, and in women who are at increased risk of infection. Screening is not currently recommended in men. In neonates and infants, the bacterium can cause conjunctivitis and pneumonia. Adults may also experience conjunctivitis caused by chlamydia. Trachoma is a recurrent ocular infection caused by chlamydia and is endemic in the developing world.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Chlamydial Pneumonia; Doxycycline; Epididymitis; Female; Humans; Incidence; Infertility, Female; Lymphogranuloma Venereum; Male; Mass Screening; Orchitis; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Pregnancy; Pregnancy, Ectopic; Prevalence; Risk Factors; Sexually Transmitted Diseases; Trachoma; Treatment Outcome; United States

Topics: Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Epididymitis; Female; Humans; Male; Nucleic Acid Amplification Techniques; Pelvic Inflammatory Disease

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents; Antitrichomonal Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Condylomata Acuminata; Doxycycline; Epididymitis; Female; Humans; Infectious Disease Transmission, Vertical; Male; Metronidazole; Papillomaviridae; Papillomavirus Infections; Pelvic Inflammatory Disease; Penicillins; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Complications, Parasitic; Scabies; Sexually Transmitted Diseases; Sexually Transmitted Diseases, Bacterial; Sexually Transmitted Diseases, Viral; Syphilis; Tumor Virus Infections; Urethritis