Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Doxycycline Versus Azithromycin for the Treatment of Rectal Chlamydia in Men Who Have Sex With Men: A Randomized Controlled Trial.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03608774 (A Phase 4, Randomized, Double-Blinded, Placebo-Controlled Trial of Azithromycin Versus Doxycycline for the Treatment of Rectal Chlamydia in Men Who Have Sex With Men), which is not on this map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
A Phase 4, Randomized, Double-Blinded, Placebo-Controlled Trial of Azithromycin Versus Doxycycline for the Treatment of Rectal Chlamydia in Men Who Have Sex With Men
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- 2023 Korean sexually transmitted infections guidelines for non-gonococcal bacterial infection (chlamydia, syphilis, etc.) by the Korean Association of Urogenital Tract Infection and Inflammation.Investigative and clinical urology · 2024Guideline
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- Impact of Changes in Chlamydia Treatment Guidelines on Recurrent/Persistent RectalOpen forum infectious diseases · 2026Article
- Mechanisms, management and prevention of anorectal sexually transmitted infections.Nature reviews. Gastroenterology & hepatology · 2026Review
- Putative azithromycin resistance mutations inAntimicrobial agents and chemotherapy · 2026Article
- US Food and Drug Administration, Centers for Disease Control and Prevention, and National Institutes of Health Co-Sponsored Public Workshop Summary-Development Considerations of Antimicrobial Drugs for the Treatment of Gonorrhea.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Trends in Chlamydia Prescribing Practices After Changes to National Treatment Guidelines in the United States, 2016-2023.Sexually transmitted diseases · 2026Article
- Repurposing epetraborole to combatAntimicrobial agents and chemotherapy · 2026Article
- Article
- Updates on Testing, Treatment, and Prevention of Sexually Transmitted Infections in the United States, 2025.Topics in antiviral medicine · 2025Review
- Epidemiological Patterns of Genital Ulcer Disease and Human Immunodeficiency Virus Among Public Clinic Attendees in Mthatha, Eastern Cape, South Africa.Diseases (Basel, Switzerland) · 2025Article
- Treatment of Chlamydia and Gonorrhea in Primary Care and Its Patient-Level Variation: An American Family Cohort Study.Annals of family medicine · 2025Article
- Antimicrobial Resistance in Curable Sexually Transmitted Infections.Current HIV/AIDS reports · 2025Review
- Update on sexually transmitted infections in Korea: a narrative review.Ewha medical journal · 2024Review
- Sexually Transmitted Infections in People with Human Immunodeficiency Virus.Infectious disease clinics of North America · 2024Review
- Zoonotic transmission ofNew microbes and new infections · 2024Article
- Clinical Updates in Sexually Transmitted Infections, 2024.Journal of women's health (2002) · 2024Review
- Efficacy of Single-Dose Azithromycin for Ocular Chlamydial Infection: A Longitudinal Study.The American journal of tropical medicine and hygiene · 2024Article
- Phenotypic and Genotypic Antimicrobial Susceptibility Testing ofAntibiotics (Basel, Switzerland) · 2023Article
- Adherence to New CDC Chlamydia Treatment Guidelines in Adolescents: Effective Uptake and Equitable Implementation.AIDS patient care and STDs · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundAzithromycin and doxycycline are both recommended treatments for rectal Chlamydia trachomatis (CT) infection, but observational studies suggest that doxycycline may be more effective.
methodsThis randomized, double-blind, placebo-controlled trial compared azithromycin (single 1-g dose) versus doxycycline (100 mg twice daily for 7 days) for the treatment of rectal CT in men who have sex with men (MSM) in Seattle and Boston. Participants were enrolled after a diagnosis of rectal CT in clinical care and underwent repeated collection of rectal swabs for nucleic acid amplification testing (NAAT) at study enrollment and 2 weeks and 4 weeks postenrollment. The primary outcome was microbiologic cure (CT-negative NAAT) at 4 weeks. The complete case (CC) population included participants with a CT-positive NAAT at enrollment and a follow-up NAAT result; the intention-to-treat (ITT) population included all randomized participants.
resultsAmong 177 participants enrolled, 135 (76%) met CC population criteria for the 4-week follow-up visit. Thirty-three participants (19%) were excluded because the CT NAAT repeated at enrollment was negative. Microbiologic cure was higher with doxycycline than azithromycin in both the CC population (100% [70 of 70] vs 74% [48 of 65]; absolute difference, 26%; 95% confidence interval [CI], 16-36%; P < .001) and the ITT population (91% [80 of 88] vs 71% [63 of 89]; absolute difference, 20%; 95% CI, 9-31%; P < .001).
conclusionsA 1-week course of doxycycline was significantly more effective than a single dose of azithromycin for the treatment of rectal CT in MSM. CLINICAL TRIALS REGISTRATION: NCT03608774.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.