zithromax and Pelvic-Pain

To evaluate the equivalence of ceftriaxone plus doxycycline or azithromycin for cases of mild pelvic inflammatory disease (PID).. Patients with PID received an intramuscular injection of 250 mg of ceftriaxone, and were randomly assigned to receive 200 mg/d of doxycycline for 2 weeks, or 1 g of azithromycin per week, for 2 weeks. The degree of pain was assessed on days 2, 7, and 14 and clinical cure was assessed on day 14.. From 133 patients eligible for the study, 13 were excluded for having conditions other than PID, 11 were lost on follow-up, and three had oral intolerance to the antibiotics, yielding 106 for protocol analysis. No significant difference was observed regarding the degree of pain between the doxycycline and azithromycin groups. Clinical cure per protocol was 98.2% (56 of 57; 95% confidence interval [CI], 0.9-0.99) with azithromycin, and 85.7% (42 of 49; 95% CI, 0.72-0.93) with doxycycline (P=0.02). In a modified intention to treat analysis, clinical cure was 90.3% (56 of 62; 95% CI, 0.80-0.96) with azithromycin, and 72.4% (42 of 58; 95% CI, 0.58-0.82) with doxycycline (P=.01); a relative risk of 0.35, and a number needed to treat of six for benefit with azithromycin.. When combined with ceftriaxone, 1g of azithromycin weekly for 2 weeks is equivalent to ceftriaxone plus a 14-day course of doxycycline for treating mild PID.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Ceftriaxone; Doxycycline; Drug Therapy, Combination; Endometritis; Endometrium; Female; Humans; Injections, Intramuscular; Pelvic Inflammatory Disease; Pelvic Pain; Treatment Outcome

To investigate the cause of chronic pelvic pain syndrome (CPPS) and the correlation between presence of bacterial signal and the response to antibiotics by detecting bacterial 16S rRNA gene signal using polymerase chain reaction (PCR).. EPS and first void urine (VB1) from 59 men with CPPS were analyzed by PCR for bacterial signal using universal primers specific for bacterial 16S rRNA gene. If the bacterial signal was found only in EPS or the EPS bacterial signal was at least 10 times stronger than the VB1 one, positive result could be decided for bacterial signal detection. All patients were treated with levofloxacin and azithromycin for 4 weeks. The treatment could be considered effective if more than 50% improvement, compared to the state before the treatment, was achieved in the symptom severity index(SSI), symptom frequency questionnaire(SFQ), national institutes of health chronic prostatis symptom index of pain(quasi-CPSI) or the patients' general subjective assessment.. Positive bacterial signal was detected in 46 of the 59 CPPS patients; The difference of improvement rates between positive bacterial signal group and negative bacterial signal group, which were 65%-74% and 0 respectively, was significant.. The basis of detecting 16S rRNA gene signal by PCR in clinical practice was built. The study shows that bacterial infection is related to CPPS. Bacterial signal detection results can help predict the effect of antimicrobial therapy.

Topics: Anti-Bacterial Agents; Azithromycin; Chronic Disease; Humans; Levofloxacin; Male; Ofloxacin; Pelvic Pain; Polymerase Chain Reaction; Prostatitis; RNA, Bacterial; RNA, Ribosomal, 16S