Trial reportSexually transmitted infections2014
Suboptimal adherence to doxycycline and treatment outcomes among men with non-gonococcal urethritis: a prospective cohort study.
Trial report in Sexually transmitted infections, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Non-standard treatment for uncomplicatedBMJ open · 2018Pooled it
- Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection.The New England journal of medicine · 2015Trial
- Mapping antibiotic treatment failure definitions and criteria in ambulatory care: a systematic literature review.JAC-antimicrobial resistance · 2026Review
- Treatment of Chlamydia and Gonorrhea in Primary Care and Its Patient-Level Variation: An American Family Cohort Study.Annals of family medicine · 2025Article
- Adherence to doxycycline for uncomplicated genitourinary chlamydia: A prospective observational study.Journal of the American College of Emergency Physicians open · 2024Article
- Diagnosis and Management of Uncomplicated Chlamydia trachomatis Infections in Adolescents and Adults: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Controversies and evidence on Chlamydia testing and treatment in asymptomatic women and men who have sex with men: a narrative review.BMC infectious diseases · 2022Review
- Azithromycin combined with doxycycline in non-gonococcal urethritis.Experimental and therapeutic medicine · 2020Article
- Molecular Typing ofMicroorganisms · 2019Article
- Treatment Effectiveness of Azithromycin and Doxycycline in Uncomplicated Rectal and Vaginal Chlamydia trachomatis Infections in Women: A Multicenter Observational Study (FemCure).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Observational
- Frequency of Prescription Filling Among Adolescents Prescribed Treatment for Sexually Transmitted Infections in the Emergency Department.JAMA pediatrics · 2019Article
- Azithromycin Efficacy in Asymptomatic Rectal Chlamydial Infection in Men Who Have Sex With Men: A More Definitive Answer Soon?Sexually transmitted diseases · 2017Article
- Treatment efficacy of azithromycin 1 g single dose versus doxycycline 100 mg twice daily for 7 days for the treatment of rectal chlamydia among men who have sex with men - a double-blind randomised controlled trial protocol.BMC infectious diseases · 2017Article
- What is needed to guide testing for anorectal and pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae in women and men? Evidence and opinion.BMC infectious diseases · 2015Article
- Treatment challenges for urogenital and anorectal Chlamydia trachomatis.BMC infectious diseases · 2015Review
- Mycoplasma genitalium infection: current treatment options, therapeutic failure, and resistance-associated mutations.Infection and drug resistance · 2015Review
- High co-occurrence of anorectal chlamydia with urogenital chlamydia in women visiting an STI clinic revealed by routine universal testing in an observational study; a recommendation towards a better anorectal chlamydia control in women.BMC infectious diseases · 2014Observational
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Authors and funding
8 authors.
Funding
Abstract
objectiveDoxycycline, one of two recommended therapies for non-gonococcal urethritis (NGU), consists of a 7-day course of therapy (100 mg 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.
methodsMen aged ≥16 years 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 ≥1 dose in 7 days. Urine was tested for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), and Ureaplasma urealyticum-biovar 2 (UU-2) using nucleic acid amplification tests. Clinical failure (symptoms and ≥5 PMNs/HPF or discharge) and microbiologic failure (positive tests for CT, MG, and/or UU-2) were determined after 3 weeks.
results184 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; 0.93-7.41, p=0.07).
conclusionsAdherence may be important for microbiologic cure of select pathogens. Factors other than adherence should be considered for CT-negative men with persistent NGU.
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