Erythromycin for chlamydia. Effective antibiotics in the treatment of chlamydia. Features of antimicrobial therapy

Treatment of chlamydia differs in its features:

• antibiotic dosages are quite high;
• often several courses of different drugs are prescribed;
• Antibacterial therapy is combined with the use of immunomodulators;
• Antibiotics for chlamydia are prescribed in the acute phase of the disease.

The pharmacological industry offers a wide range of antibacterial agents, however, selecting a drug and calculating an adequate dosage is not easy. In each case, the doctor approaches the development of a treatment regimen individually. After all, chlamydial infection can be aggravated by other infectious processes, and the immunity of all patients is different.

The situation is further aggravated by the fact that the drug does not work during repeated treatment of chlamydia - they adapt to its formula. If the patient has previously had an infection, it is necessary to select another drug with the same effect, but a different dosage formula.

In addition to taking capsules and injections, local products are used - suppositories, ointments and creams.

If it is impossible to defeat the infection with the selected treatment regimens, the patient is tested for the strain of bacteria to find out the cause of drug resistance. It takes time and costs money. However, only after laboratory testing can a suitable drug be selected.

Treatment rules

Patients must understand that treatment with antibacterial agents requires strict adherence to certain rules, otherwise the effect will not be achieved. Bacteria behave like completely intelligent creatures and try to survive in any conditions, so only strict adherence to the adjusted dosage and medication regimen will help defeat the infection.

Follow the instructions:

• medications are taken strictly at the prescribed time;
• after the symptoms disappear, antibiotics are continued for the time specified by the doctor;
• the course is prescribed to both sexual partners, even if one of them has no signs of infection;
• before starting treatment, you should pass all the required tests, on the basis of which a treatment regimen will be developed;
• During treatment, sexual activity is completely excluded.

Remember that neglecting one of the instructions will lead to unpredictable results.

The antibiotic treatment regimen for chlamydia is the same for men and women. The dosage of drugs is determined individually.

The acute course of the disease involves three stages:

• preparing the body to take antibiotics using immunomodulators and treating infected areas with Chlorhexidine;
• use of prescribed medications - 7/10/14 days;
• restoration of disturbed intestinal microflora and liver cells.

The chronic course changes the scheme of therapeutic procedures:

1. The first stage involves the use of antibacterial agents together with immunomodulators, antioxidants and vitamin complexes.
2. The second stage consists of using antifungal agents and enzymes.
3. The third stage consists of taking medications that restore the liver, as well as visiting a physiotherapy room.

Thus, the chronic stage is subject to three weeks of treatment with drugs, the acute form is treated within two weeks. The duration is due to the destruction of chlamydia at all stages of development.

Description of drugs

Antibacterial drugs have either a broad spectrum of action, that is, they destroy bacteria throughout the body, or they fight specific types of microorganisms. In the case of chlamydia treatment, drugs are needed that can destroy bacteria in intracellular structures. However, chlamydia is complicated by the addition of other forms of microorganisms, which together with it attack the human reproductive organs and cause severe inflammatory processes.

Therefore, doctors prescribe a set of medications that can fight all types of genital tract infections. There are three large groups of medications for this:

1. tetracyclines;
2. fluoroquinolones;
3. macrolides.

Other medications cannot have an adequate effect on these microorganisms, so they are not effective. Incorrectly selected medications will not only not have a positive effect on the course of healing, but may increase the activity of bacteria and their proliferation.

Tetracyclines

Tetracycline and, as its derivative, can overcome a fresh infection in the body, which has not yet had time to strengthen its position. Tetracycline preparations are prescribed for use at 400 mg x 4 times for a week or two. The drug doxycycline has a different regimen - 100 mg x 2 times a day.

Doxycycline is considered the most effective for chlamydia, however, it has strong side effects. These include a disorder of the functionality of the gastrointestinal tract, and the occurrence of thrush, stomatitis or glossitis. However, this applies to patients with severely weakened immune defenses.

Note! Tetracycline group drugs destroy bone structure and tooth enamel. These drugs are prescribed to children after eight years of age; they are contraindicated for pregnant women.

The next active antibiotic is Azithromycin. This drug also causes unwanted side effects associated with gastrointestinal upset, so sensitivity testing should be performed before use. If side effects increase, you should notify your doctor. In case of intolerance to the drug, the doctor will select a less effective, but safe for the body.

Unidox Solutab based on doxycycline monohydrate is best tolerated by patients, as it does not have a strong negative effect on the body. It is recommended for use by patients with gastric problems - it does not irritate the mucous membrane.

Macrolides

This group of drugs is not as toxic as tetracyclines, but no less effective. The medications are well tolerated by patients and do not have significant side effects.

Note! Macrolide antibiotics are the best treatment for chlamydia.

Among macrolides, you can choose many drugs, for example, Sumamed, Erythromycin or Macropen. Erythromycin is taken according to the regimen of 500 mg x 2 times or 250 mg x 4 times for seven days. However, this antibiotic is often poorly tolerated by patients, as it has a high degree of toxicity.

However, when using the ointment, treatment should be completed, otherwise the disturbed infection will develop more actively than during the primary infection.

Important! Antibiotics for chlamydia in men cannot be combined with alcohol and spicy foods.

Patients are more often prescribed Rovamycin, which has a minimal toxic effect on the body and effectively relieves inflammation in the lesions. This antibiotic can also be taken by pregnant women.

Sumamed is very effective in the fight against chlamydia, in addition, it also suppresses the activity of gonococci. Sumamed is also prescribed for gonorrhea. The active substance of the drug has the ability to accumulate in the affected areas, maintaining stability for up to five days. The treatment regimen involves taking the medicine one 500 mg capsule for a week or 250 mg for two weeks. This is determined by the doctor.

Fluoroquinolones

Fluoroquinolones are used when the first two groups of antibiotics for chlamydia have no effect in treatment. In this case, Ofloxacin is most often prescribed, which is used once a day at 400 mg or twice a day at 200 mg. Duration of treatment is up to nine days. The drug Ciprofloxacin is also prescribed, but less frequently - most strains show resistance to this medicinal formula.

Drugs of this group are successfully used in the treatment of mixed infections and chronic infections. However, medications should not be used to kill chlamydia in pregnant women and young children.

Antifungal agents

Since fungi are often associated with chlamydia, patients are also prescribed antifungal drugs. Fungal activity is caused by an imbalance of microflora in the body, since antibiotics destroy all bacteria indiscriminately. Fungi receive fertile soil for reproduction.

Among the antifungal agents, the following medications are widespread:

• Trichopolum;
• Metronidazole;
• Fluconazole;
• Natamycin;
• other.

Immunomodulators

The drug Polyoxidonium is usually prescribed, which works well in the treatment of sexually transmitted infections. In addition to strengthening the immune system, Erbisol has a beneficial effect on liver cells. Immunomodulators are administered intramuscularly. Interferon group drugs and enzymes may also be prescribed.

The latter free the body from toxic substances produced by bacteria and strengthen the immune system. To support the liver, it is good to use Essentiale Forte or Karsil.

Probiotics

This group of drugs is prescribed to restore disturbed intestinal microflora. The disorder is caused by the use of potent drugs that destroy both beneficial bacteria and harmful ones. If you do not use probiotics, digestive and intestinal problems are inevitable. As a rule, the patient suffers from stool disorder - diarrhea.

List of beneficial probiotics:

• Lactobacterin;
• Bifiform;
• Bifidobacterin;
• Linux;
• Enterol;
• Bificol.

These drugs cannot be used independently - only after the approval of a doctor. They contain living bacteria that help in the proper processing of food.

Physiotherapy and baths

Antibiotics for chlamydia in women and men are supplemented with physiotherapy and local therapy. Baths with Chlorhexidine relieve the condition and quickly relieve symptoms. Various disinfectants are also used to administer micro-enemas.

Physiotherapy accelerates the body's recovery. For this purpose, electro- and laser phoresis, magnetic therapy, and a procedure using ultrasound are prescribed.

After completing the therapeutic course, the patient must undergo tests to ensure the effectiveness of the treatment. Analyzes include:

• microflora test.

Antibiotic therapy is used to treat chlamydia

Main aspects of treatment

In most cases, treatment of chlamydia is carried out through the use of complex therapy, including both antibiotics and the use of topical agents. The choice of a medication classified as an antibiotic is based on compliance with a number of aspects:

Treatment begins only after tests have been carried out and the exact causes of the disease have been established.

• In the presence of concomitant diseases of a similar etiology, the prescription of a number of broad-spectrum antibiotics is required.

Important! When treated with antibiotics, immunomodulatory drugs and agents that restore the beneficial microflora of the digestive system are also often prescribed.

Predominant antibiotics

Currently, in the field of practical medicine, various antibiotics are used for chlamydia in acute and chronic forms in women and men. But the drug called Doxycycline is rightfully recognized as the most effective. The active components of the drug are destructive to most known strains of the microorganism; the effectiveness of this medication is difficult to overestimate.

Doxycycline is often used to treat chlamydia.

However, the use of Doxycycline entails a lot of side effects and contraindications. Negative reactions from the body include, for example, various disorders of the digestive tract, as well as the development of candidiasis, commonly referred to as thrush.

In addition, Azithromycin is among the most effective drugs aimed at eliminating chlamydia. The use of this medication is also associated with the possible occurrence of a host of side effects, including nausea, vomiting, and other types of digestive tract disorders.

Despite direct and relative contraindications and possible side effects, Doxycycline and Azithromycin are the most effective remedies for chlamydia. To reduce the likelihood of negative reactions from the body, it is necessary to take immunomodulatory drugs and probiotics.

The second most popular drug for the treatment of chlamydia is Azithromycin.

Other types of antibiotics

Antibiotics for chlamydia are drugs that are recognized for their effectiveness and inhibit the ability to function in most known strains of chlamydia. Take strong medications only as prescribed by your doctor. The choice of drug depends on the individual characteristics of the patient, possible cumulative diseases, test results, as well as a number of other aspects.

The most effective and relatively safe antibiotic agents include, for example:

• Erythromycin. A drug used in the treatment of a wide range of urogenital infections of various etiologies.
• Chemomycin. A macrolide drug with a powerful antibacterial effect.
• Clarithromycin. A medicinal antibacterial agent most often used in the treatment of sexually transmitted infections.

Drugs prescribed to combat chlamydia

• Amoxicillin. Broad-spectrum antibacterial drug. These antibiotics do not act on most strains of chlamydia, so the drug is used in the treatment of the corresponding disease quite rarely.
• Josamycin. A relatively new drug, the use of which is practically free of side effects.
• Macropen. One of the safest remedies that can be used even by pregnant women.
• Sumamed. One of the most effective antibiotic drugs, the use of which is associated with a minimal risk of side effects.
• Klacid. A highly effective remedy used both in the treatment of chlamydia and other infectious and viral diseases.

The presented drugs are effective against chlamydia

Chlamydia (the main causative agent) is a sexually transmitted sexually transmitted disease. It is considered one of the most common diseases of this type (about 90 million people are infected per year). The structure of chlamydia trachomatis is similar to a common bacterium, so this dual nature often makes diagnosing the disease difficult. It affects the genitourinary system and appears after an incubation period (5–30 days) with a number of additional pathologies. Both men and women are equally susceptible to the disease.

First of all, you should remember that antibiotics for chlamydia will only work if you take them strictly according to the schedule, as indicated in the instructions and as advised by your doctor. If you skip a dose or stop treatment early, the disease is likely to reactivate. During therapy, it is necessary to avoid sexual contact, especially unprotected sex.

If, after correct and accurate treatment, the symptoms do not disappear or return, you need to contact your doctor again. It is advisable to be examined again after 4 months or 1 year after getting rid of chlamydia. This will help prevent the disease from returning and reduce the risk of further pelvic disease. There is no need to self-medicate or try to choose an antibiotic yourself. Is it dangerous.

Undesirable effects on the body

The most common side effects are nausea and vomiting. Tetracycline is most often well tolerated by adult patients. Possible damage to the digestive system, kidneys, liver and the development of pancreatitis. In rare cases, patients were found to have photophobia, unsteady gait, pigment spots on the skin, mucous membranes or teeth, and intracranial pressure.

Macrolides are considered one of the safest antibiotics in terms of side effects, but they have almost identical symptoms along with Tetracycline and its analogues. In rare cases, the following signs were found:

Fluoroquinolones, in addition to all of the above side effects, can also cause tendinitis (inflammation in the tendons) and tendon ruptures.

A side effect can occur both on the first and last day of taking the drugs. The risk increases when used together with steroids.

Types of drugs

Antibiotics for the treatment of chlamydia are divided into several subtypes:

• macrolides;
• tetracycline;
• fluoroquinolones.

Macrolides- a class of antibiotics based on a macrocyclic lactone ring. They are positioned as the safest, most effective and efficient drugs for the treatment of this disease. This group includes natural antibiotics (Erythromycin, Spiramycin, Josamycin and Midecamycin) and semi-synthetic (Clarithromycin, Roxithromycin,) macrolides.

Contraindications include hypersensitivity. Spiramycin, Josamycin and Clarithromycin can be taken regardless of meals, the rest 1-2 hours before meals, depending on the instructions on the package. For better absorption, it is advisable to take erythromycin with a whole glass of water. This drug is considered the most effective in this group of drugs.

Tetracycline- a broad-spectrum antibiotic, including its use for a number of sexually transmitted diseases. The drug is released in the form of tablets, which are taken orally during or after meals 3-4 times a day. On average, the course of treatment lasts a week, after which the treatment continues for several more days for preventive purposes.

Tetracycline is not taken with dairy products, since they almost completely absorb all the substances necessary to get rid of the virus. It is contraindicated for fungal infections, liver and kidney dysfunction. Analogs of Tetracycline (included in the composition) are the following:

• Metacycline (300 mg twice daily during or after meals);
• Vibramycin (100 mg twice daily);
• (200 mg twice daily);
• (100 mg twice daily).

Fluoroquinolones (quinolones)- a group of drugs that is less effective and has a number of side effects. But they destroy well:

• gonococcus (a microbe that causes gonorrhea and is most often sexually transmitted);
• mycoplasma (more often in women);
• gardnerella (in excess quantities cause diseases of the vagina and pelvic organs in women and genitourinary organs in men).

Fluoroquinolones include Ofloxacin, Abaktal, Maxaquin and Tsiprobay. To treat chronic chlamydia, complex treatment in the form of several antibiotics is often prescribed or other antibacterial drugs and types of therapy are additionally prescribed. Therefore, only the attending physician can tell you whether a specific ailment can be cured with a drug.

Antibiotics during pregnancy

During pregnancy, most antibiotics are contraindicated as they can have a negative impact on the further development of both mother and child. It is necessary to select a product whose molecules are too large and cannot pass through the placenta, but at the same time can rid the woman of pathogenic microorganisms. Since macrolide antibiotics are considered the safest, they are recommended to be taken during this period.

Chlamydia can be treated either with a single dose of an antibiotic or with complex treatment, where immunomodulators and enzymes will be prescribed. Several molecules will still cross the placenta, so therapy during this period should be longer, but carried out in short courses.

Russian doctors consider the following antibiotics to be the safest for treating chlamydia during pregnancy:

1. Azithromycin (semi-synthetic macrolide).
2. Erythromycin (natural macrolide).
3. Josamycin (natural macrolide).
4. Amoxicillin (group of aminopenicillins).

European scientists recommend similar treatment regimens, but exclude the use of Azithromycin and offer it only as an alternative. The fact is that it is not recommended for the treatment of chlamydia, but a number of scientists who conducted studies have proven that this particular drug most often successfully gets rid of chlamydia in pregnant women. At the same time, the drug caused practically no side effects and did not affect the further development of the fetus. Research into this type of therapy is ongoing.

During treatment, Viferon is often prescribed. This drug is indicated from the 14th week of pregnancy and is recommended for the treatment of premature babies, so there is no doubt about its effectiveness. Viferon prevents the further spread of the disease and restores the body's defenses. Does not cross the placenta and does not pass into breast milk.

To treat bacterial infections of various locations (genitourinary system, abdominal cavity, upper respiratory tract), drugs based on an active substance such as ornidazole, which is compatible with many other drugs, are used. This allows for more effective drug therapy in case of severe illnesses.

Ornidazole is a nitroimidazole group of antibiotics that has high activity against anaerobic bacteria, as well as pathogens of protozoal infections. It penetrates almost all fluids and tissues of the body and is already active three hours after a single dose. This active substance is eliminated within five days after the first dose.

A drug like Ornidazole has positive reviews, although it has a fairly wide range of side effects. Therefore, the patient is obliged to notify the attending physician about existing chronic diseases in order to adjust the treatment.

This medicinal substance is used for antibacterial and antiprotozoal therapy, providing bactericidal as well as bacteriostatic effects. When taken orally, almost 95% is absorbed from the digestive tract.

Due to the fairly high penetration of ornidazole into almost all tissues and organs, this allows it to be prescribed for pathological processes of any localization that have arisen due to protozoal or anaerobic infections.

The most popular and cheapest drug based on the above active ingredient is Ornidazole obl, which has a lot of analogues, but they are more expensive.

Doctors prescribe this drug to combat the following diseases:

• genitourinary system infections;
• purulent-inflammatory processes of the pelvis in women;
• amoebic dysentery;
• giardiasis;
• amoebic abscess of the liver and brain;
• prevention of infectious infections during operations.

The action of such a drug disrupts the processes of DNA replication and transcription, has a cytotoxic effect, and also destroys the processes of cellular respiration of bacterial microorganisms. Thanks to this, a bacteriostatic effect is also achieved.

There are a large number of drugs based on ornidazole, which can be supplemented with other active ingredients, which expands their range of actions. For this purpose, below are complete descriptions of various medicinal combinations with ornidazole, as well as other drugs from the fluoroquinolone series.

Ornidazole ofloxacin

There is a group of drugs based on the active ingredients - ornidazole and ofloxacin, for example:

1. Iflox;
2. Tiphlox;
3. Polymik.

Such drugs are well tolerated even by the elderly and seriously ill. They are perfect for the treatment of mixed infectious diseases that require combined antibacterial agents, which are embodied in the above drugs.

Ofloxacin rarely develops resistance to pathogenic microorganisms. Its bioavailability after oral administration is about 98% and is completely absorbed from the digestive tract.

Ofloxacin was the first antibacterial drug based on fluoroquinol. At the present time, medications based on fluoroquinol are the most common for the treatment of infectious diseases and purulent-inflammatory processes.

This active substance covers gram-negative as well as gram-positive aerobic and anaerobic microorganisms. It can penetrate the tissues of the female internal genital organs (uterus, ovaries, fallopian tubes), which allows its use in the field of gynecological diseases.

Drugs such as Iflox, Polymic and their analogues can be used in various branches of medicine, and in cases where a powerful and effective antibacterial agent is required.

In urology, the above drugs treat:

• chronic and acute pyelonephritis;
• cystitis;
• urethritis;
• various urinary tract infections, etc.

They are also prescribed for the treatment of sexually transmitted diseases that are caused by:

1. gonococci;
2. chlamydia and other pathogenic microorganisms.

It is worth noting that the active ingredients ornidazole and ofloxacin perfectly complement each other in the fight against various infections and allow doctors to prescribe it as the main therapy.

At the same time, drugs based on them are characterized by a low price.

Ciprofloxacin ornidazole

Drugs that are based on ciprofloxacin and ornidazole are considered complex antimicrobial and antiprotozoal agents that have a wide spectrum of action on infectious diseases of various etiologies.

Such drugs include:

• Combiflox;
• Ofor.

They are identical in composition (analogues), and the price of Orcipol will be 155 rubles, and its analogue Combiflox will be 650 rubles.

The active substance ciprofloxacin belongs to the second generation of fluoroquinolone. It inhibits the synthesis of bacterial DNA and inhibits them, which promotes morphological changes in the membrane and cell wall of the harmful bacterium. All this leads to her death.

Ciprofloxacin affects bacteria both in a state of growth and in a state of rest. It has a broad spectrum of antimicrobial action and penetrates almost all tissues and fluids of the body.

About half of the drug is excreted in the urine, 20% in the feces. The half-life of ciprofloxacin will be from 3 to 5 hours. If this active substance is taken by elderly people, or with liver disease, the half-life can last up to 8 hours.

Ciprofloxacin ornidazole together fights well against the following diseases:

1. abdominal infections;
2. infections of the pelvic organs (uterus, fallopian tubes, ovaries);
3. gonorrhea, chlamydia, prostatitis, cystitis;
4. ENT infections (bronchitis, pneumonia, etc.);
5. infections of the skin, mucous membranes;
6. sepsis.

A drug such as Orcipol (based on ciprofloxacin and ornidazole) is prescribed in the postoperative period to prevent the development of infections.

The instructions for use are quite simple, but the patient must carefully read them, due to the fact that different diseases require their own doses of the drug.

What remains unchanged is that the tablets should be taken orally two hours before meals or after. They cannot be chewed or divided in half. On average, the course of treatment ranges from 5 to 7 days.

If drug therapy is prescribed in tablets, then they should be taken 1 piece at a time. twice a day. After the disappearance of clinical symptoms, continue the course of treatment for another three days.

If the attending physician has not prescribed a dosage, you should adhere to the instructions with the following daily doses: for adults, for infections of the urinary tract and genital organs, 1 tablet twice a day, at equal intervals. For cystitis (before menopause), uncomplicated gonorrhea, 1 tablet once.

For children, the daily dose is calculated according to their body weight, from 10 to 20 mg/kg, every 12 hours. The maximum dose of the active substance ciprofloxacin should not exceed 750 mg per day.

For elderly people, that is, over 65 years of age, the dosage should be prescribed only by a doctor and be as low as possible.

Orcipol is contraindicated:

1. children under 15 years of age;
2. pregnant women;
3. lactation period.

Only the attending physician can prescribe Orcipol to the above categories of people, assessing the risk-benefit ratio of the patient.

Metronidazole

Metrodinazole is an antimicrobial, antiprotozoal and antiulcer drug.

The active substance metrodinazole interacts with the DNA cells of harmful microorganisms, inhibiting their synthesis of nucleic acids, which causes the death of microorganisms.

Drugs that contain metrodinazole are presented below; they can be administered orally, locally, rectally and intravenously:

• Metron;
• Batsimex;
• Klion.

The drug is active against many gram-positive bacteria, as well as Trichomonas vaginalis, Gardnerella vaginalis, Giardia intestinalis, Entamoeba histolytica, obligate anaerobic bacteria such as Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus), Fusobacterium spp., Veillonela spp., and Helicobacter pylori, which contributes to the formation of ulcers.

After oral administration, Metronidazole is well absorbed into the gastrointestinal tract and penetrates into almost all tissues and fluids of the body. That is why its use is contraindicated during lactation, due to the release of the active substance into breast milk. Within eight hours, about half of the drug is eliminated, 60% of which is through urine.

The range of uses of the active substance metrodinazole is quite wide. It is prescribed for the following diseases:

1. giardiasis;
2. liver abscesses;
3. pelvic organ infections;
4. abdominal infections;
5. prevention of infectious infections in the postoperative period.

For patients who have problems with liver function, it is necessary to adjust the dosage regimen of the drug by monitoring it in the blood serum.

Metronidazole is prescribed quite often for chlamydia and is considered one of the most effective drugs for this disease, although this disease is not indicated in the instructions. All this is due to the fact that chlamydia itself is often burdened by other infections.

Typically, drug therapy is supplemented with drugs based on amoxicillin, which suppresses the development of resistance in bacteria to the active substance metrodinazole.

When taking it, the following side effects may occur:

• metallic taste in the mouth;
• gastrointestinal disorder;
• headache;
• allergic rash;
• insomnia, or fatigue.

If one of these factors occurs, then the patient diagnosed with chlamydia must notify the attending physician.

Norfloxacin

This active substance also belongs to the fluoroquinolone series of antibiotics and is a broad-spectrum antibacterial agent. Based on it, there is a frequently prescribed drug - Nolitsin, which is used for the following diseases:

1. chronic and acute infections of the genitourinary system;
2. gonorrhea;
3. urinary tract relapse;
4. gastroenteritis, bacterial etiology.

Nolitsin is distinguished by the fact that it has relatively few side effects: disruption of the gastrointestinal tract, allergic reaction, nervous system disorder, changes in blood and urine formula (reversible) and heart rhythm disturbances.

This drug is not prescribed to children under the age of 15 years, pregnant women and during the lactation period, since the main active ingredient is absorbed into almost all tissues and liquids, which can harm the fetus. Metronidazole, as the main drug from Ornidazole analogues, will be discussed in the video in this article.

Azithromycin treatment regimen for chlamydia

Currently, there are many diseases that are widespread in the modern world and have become epidemics. Chlamydia is one such disease. To combat chlamydia, various drugs are used, most often antibiotics. Azithromycin is one of them. From this article you will learn a treatment regimen for chlamydia with azithromycin.

Epidemiology of chlamydia

Chlamydial infection occupies one of the leading places in the structure of all STIs. Every year, about 90 million new diseases are registered worldwide. In Russia, more than 1.5 million people become ill with urogenital chlamydia every year (incidence records have been kept since 1993). Most often, men and women of sexually active age (20–40 years) suffer from chlamydia; the incidence rate has increased among adolescents aged 13–17 years. The frequency of infection in pregnant women ranges from 10 to 40%, and with a complicated gynecological history (salpingo-oophoritis, TPB, miscarriage) - from 49 to 63%. The source of infection is persons with manifest or asymptomatic urogenital chlamydia.

Routes of transmission of chlamydial infection.

• Contact: ♦sexual; ♦non-sexual (domestic, possibly family).
• Vertical: ♦antenatal; ♦intranatal.

Classification of chlamydia

According to the severity of the flow, they are distinguished:

• fresh chlamydia (uncomplicated chlamydia of the lower genitourinary tract);
• chronic chlamydia (long-term, recurrent, persistent chlamydia of the upper genitourinary tract, including the pelvic organs).

Based on the topography of the lesion, the following are distinguished:

• chlamydial lesions of the lower genitourinary tract (urethritis, bartholinitis, endocervicitis, vaginitis);
• ascending chlamydial infection (endometritis, salpingitis, salpingoophoritis, pelvioperitonitis, perihepatitis).

Etiology and pathogenesis of chlamydia

Chlamydia has a unique developmental life cycle. It is represented by two cellular forms: highly infectious elementary bodies that do not exhibit metabolic activity and reproductive intracellular reticular bodies. The intracellular development cycle of chlamydia (the transition of elementary bodies into reticular bodies and back) takes 24–72 hours. Then the affected cell is destroyed and many newly formed elementary bodies enter the intercellular spaces, capable of infecting new cells. The incubation period varies from 5–7 days to 3–6 weeks, with an average of 21 days.

Chlamydia is unstable in the external environment, sensitive to high temperature and quickly inactivated when dried. Highly sensitive to 70% ethanol, 2% Lysol, 0.05% silver nitrate, 0.1% potassium iodate, 0.5% potassium permanganate, 25% hydrogen peroxide, 2% chloramine, UV rays.

The humoral immune response is characterized by the production of specific IgM, IgG, IgA. IgM can be detected in the vascular bed within 48 hours after infection. Only 4-8 weeks after infection are antibodies of the IgG class detected. Secretory IgA is formed locally. The production of antibodies, as well as phagocytosis by macrophages, are possible only when chlamydia are in the elementary body (EB) stage in the intercellular space. Therefore, when chlamydia persists inside the cell at the RT stage, the amount of IgG antibodies in the blood is usually small.

The chronic course of chlamydia is characterized by the presence of IgA and IgG. Low, constantly existing titers of IgG antibodies indicate a long-standing chlamydial infection.

The most common clinical forms of chlamydia: acute urethral syndrome, bartholinitis, cervicitis, endometritis, salpingitis, conjunctivitis, salpingoophoritis, pelvioperitonitis. A serious complication of chlamydia is infertility.

Asymptomatic chlamydial infection is noted depending on the location with a frequency of up to 60–80%. Due to the common routes of transmission of pathogens in STIs, chlamydia is often accompanied by other bacteria and viruses (gonococci, trichomonas, myco, ureaplasma, HSV, CMV, human papillomavirus), which in association increase the pathogenicity of each microorganism and its resistance to treatment.

The following stages are distinguished in the pathogenesis of chlamydial infection:

• infection;
• formation of the primary focus of infection;
• progression of the inflammatory process with multiple lesions of epithelial cells and the appearance of clinical symptoms of the disease;
• functional and organic changes in various organs and systems against the background of developing immunopathological reactions.

Screening and initial consultation for chlamydia

Screening is carried out using PCR and enzyme immunoassay methods. Subject to examination:

• persons who have had sexual contact with patients with urogenital chlamydia;
• persons being tested for other STIs;
• women with mucopurulent discharge from the cervical canal, symptoms of adnexitis, infertility, miscarriage;
• newborns from mothers who have had a chlamydial infection during pregnancy;
• men with mucopurulent discharge from the urethra, symptoms of dysuria.

Preventive measures should promote a healthy sexual lifestyle, inform the population about the routes of infection, early and late clinical manifestations of infection and methods of their prevention (safe sex).

Diagnosis of chlamydia

Diagnosis of urogenital chlamydia is based on an assessment of the epidemiological history, clinical picture, and laboratory test results. There is a high risk of infection in people with multiple and casual sexual relationships.

Clinical manifestations of urogenital chlamydia are quite wide: from the absence of specific symptoms to the development of manifest forms of the disease. Moreover, the asymptomatic course of the disease does not exclude ascending infection of the uterine cavity and its appendages. The clinical picture of chlamydial infection is determined by the virulence of the pathogen, the duration of persistence of chlamydia, the location of lesions and the state of the human immune system.

The following options for damage to the lower genitourinary tract are possible:

• urethritis (more often in children and men);
• paraurethritis;
• bartholinitis;
• endocervicitis;
• vaginitis

Ways of spreading of ascending infection:

• canalicular (through the cervical canal, uterine cavity, fallopian tubes to the peritoneum and abdominal organs);
• hematogenous (extragenital lesions; for example, pharynx, joint capsules);
• lymphogenous (via lymphatic capillaries);
• sperm;
• via VMC.

Clinical forms of ascending chlamydial infection:

• salpingitis and salpingoophoritis (most often they have a subacute, long-term course without a tendency to worsen);
• endometritis (rarely acute, often chronic);
• infertility (sometimes this is the patient’s only complaint).

Complications of chlamydia

• ectopic pregnancy;
• complete or partial obstruction of the fallopian tubes;
• adhesions in the pelvis;
• chronic pelvic pain syndrome;
• miscarriage;
• perihepatitis;
• Reiter's disease (cervicitis, arthritis, conjunctivitis).

Drug treatment of chlamydia

• azithromycin, orally 1 g once for an uncomplicated form, for a complicated form - 500 mg 2 times a day for 7–10 days;
• doxycycline, orally 100 mg 2 times a day for 7 days;
• josamycin, orally 500 mg 3 times a day for 7 days;
• clarithromycin, orally 250 mg 2 times a day for 7 days;
• roxithromycin, orally 150 mg 2 times a day for 7 days;
• ofloxacin, orally 200 mg 2 times a day for 7 days.

For complicated forms of urogenital chlamydia, the same drugs are used, but the duration of treatment is at least 14–21 days.

Alternative treatment regimens for chlamydia:

• erythromycin, orally 250 mg 4 times a day for 14 days;
• lomefloxacin, 400 mg once a day for 7–10 days.

In order to prevent candidiasis during antibacterial therapy for chlamydia, it is advisable to prescribe antifungal drugs: nystatin, natamycin, fluconazole, itraconazole. In case of co-infection with C. trachomatis, trichomonas, urea, mycoplasmas, anaerobic microflora (in pathogenic concentrations), the treatment regimen should include protistocidal drugs from the very beginning: metronidazole orally 500 mg 2 times a day for 7 days.

In case of recurrent chronic chlamydia, the use of immunomodulators is pathogenetically justified, since they normalize the immune status and participate in the elimination of chlamydia by directly inhibiting their replication and transcription:

• meglumine acridone acetate, 12.5% ​​solution 2 ml intramuscularly every other day for 5 to 10 injections;
• sodium oxodihydroacridinyl acetate (neovir ©), 250 mg intravenously per 1 ml of 0.5% procaine solution daily 10 injections;
• IFN alpha2, 1 suppository vaginally at night every day for 10 days. Enzyme preparations are used: Wobenzym©, chymotrypsin.

Advantages of Azithromycin as an antibiotic for chlamydia and dosage

Azithromycin (a subclass of azalides) has virtually revolutionized the treatment of chlamydial infection. This is one of the most widely studied antibiotics for chlamydia, its effectiveness reaches 96%.

• Azithromycin is especially effective for chronic persistent genital chlamydia.
• The advantage of Azithromycin is that it works after taking a single dose. But the sufferer will have to wait seven days after completing treatment before they can have sex again.
• Azithromycin is recommended as first-line treatment for genital chlamydial infection during pregnancy. There is evidence of the safety and effectiveness of the drug for pregnant women.
• In addition, recent studies suggest that Azithromycin, with its immunomodulatory effects, may be preferable to Doxycycline for the treatment of recurrent Ch. trachomatis associated with infertility.
• Azithromycin is taken 1 g orally in a single dose. Or 500 mg in one dose on 1 day, then 250 mg once a day for two days.

For indolent forms of the disease, doctors usually prescribe complex inpatient treatment: antibiotics in combination with immunotherapy. Its duration is determined by the doctor, based on the general condition of the patient and the degree of neglect of the disease.

Azithromycin for urethritis of non-chlamydial etiology

Azithromycin exhibits high activity not only against chlamydia, but also other infections that can be transmitted through sexual contact: Ureaplasma urealyticum, Mycoplasma genitalium, Neisseria gonorrhoeae and Haemophilus ducreyi. Mycoplasma hominis is resistant to azithromycin in most cases.

Azithromycin is also active against gram-positive (St. aureus, St. epidermidis, including strains producing beta-lactamases, various types of streptococci, with the exception of strains resistant to macrolides and enterococci) and gram-negative flora (Haemophilus influenzae, Moraxella catarrhallis, etc. ). These microorganisms can also be found in the genitourinary tract, but their role in the occurrence of urethritis has not been proven.

Recommendations for the use of azithromycin for chlamydial infection

For the treatment of patients with chlamydial infection of the lower parts of the urogenital tract, all of the above guidelines, as the method of choice, recommend a single dose of azithromycin at a dose of 1.0 grams, 1 hour before meals or 2 hours after, if the drug is used in capsules, or regardless of meals when taking pills. Another drug of choice is doxycycline, which is prescribed 100 mg 2 times a day for 7 days.

The disadvantages of azithromycin compared to doxycycline could include the higher cost of azithromycin. However, according to the results of pharmacoeconomic studies conducted by the CDC, the higher cost of azithromycin compared with doxycycline is offset by lower costs associated with the treatment of PID, ectopic pregnancy and infertility arising from inadequate therapy associated with non-adherence to the prescribed treatment regimen, which is much more common in prescribing doxycycline.

The advantages of azithromycin over doxycycline, in addition to higher treatment compliance, include better tolerability, as well as the possibility of use in adolescents.

For many years, there was no reliable data on the isolation of C. trachomatis strains resistant to macrolides. The first reliable report of the isolation of C. trachomatis strains from 3 patients for which the azithromycin MIC was higher than 4.0 μg/L was published in 2000 (Somani J. et al, 2000). In addition to resistance to azithromycin, resistance to doxycycline and ofloxacin was also detected in the isolated strains. The mechanisms of C. trachomatis resistance to macrolides have not yet been studied, and its detection is associated with significant methodological difficulties.

In this case, cross-resistance to other macrolides may occur. So far, rare reports of antibiotic resistance of chlamydia to azithromycin have no clinical significance and have not led to changes in existing recommendations for the treatment of chlamydial infection with this antibiotic.

Drugs for the effects of chlamydia and its treatment for men and women

One of the negative effects of antibacterial drugs for chlamydia for men and women is that they are not selective in choosing microorganisms to “eliminate.” During treatment, good bacterial colonies in the intestines die along with the “pests”.

It leads to:

• weakening of immune function;
• hormonal imbalance;
• skin itching;
• insomnia;
• and even mood disorders such as unexplained anxiety.

Therefore, after treatment for chlamydia, it is important to take immediate steps to restore gut health.

For this purpose, doctors prescribe:

• Prebiotics are complex carbohydrates (inulin, lactulose), which are an activator of the growth of beneficial microorganisms found in the intestines.
• Preparations with prebiotics. They contain beneficial microorganisms that populate the colon and perform functions in the production of certain vitamins (such as B12), help digest food and lower cholesterol, and neutralize toxins that are formed during digestion. And this is only part of their useful work.

To restore and strengthen the immune system after chlamydial infection, the following are used:

• multivitamins;
• herbal immunostimulants;
• medications from the interferon drug group (for example, Viferon).

Systemic enzyme therapy using the drugs Wobenzym, Phlogenzyme and Wobe-mugos E has an effect on the body as a whole, allowing it to “catch” free radicals and have a beneficial effect on the components of the immune system at the cellular and molecular level.

Conclusion

Thus, the unique pharmacokinetic characteristics of azithromycin are a long half-life, high level of absorption and stability in an acidic environment, the ability of this antibiotic to be transported by leukocytes to the site of inflammation, high and prolonged concentration in tissues, the ability to penetrate into cells, as well as simple regimens of use, high clinical the effectiveness and compliance of treatment, low toxicity maintain the position of azithromycin as the main drug in the treatment of chlamydial urethritis in men and other pathologies associated with chlamydial infection.

Sources:

• www.medsecret.net/ginekologiya/mochepolovye-infekcii/92-hlamidioz
• http://impotencija.net/hlamidioz/antibiotiki/
• https://www.lvrach.ru/2008/01/4758161/

About the unfriendly union of Trichomonas and Chlamydia

Among the most common sexually transmitted diseases, trichomoniasis and chlamydia occupy leading positions. The clinical manifestations of these pathologies are largely similar, and the methods of diagnosis and treatment are not very different.

The main danger of chlamydia and trichomoniasis is that they negatively affect the human reproductive system, so you should know prevention methods to avoid infection.

Relationship between trichomoniasis and chlamydia

The symptoms of both pathologies are more pronounced in women; in men they often occur in a latent form, without any special signs, which makes timely treatment difficult.

Are trichomoniasis and chlamydia the same thing? Both infections can develop simultaneously, since chlamydia and trichomonas often live simultaneously in the human body.

Symptoms of trichomoniasis

Manifestations of pathology

Signs of chlamydia

Symptoms of chlamydia

Treatment of combined infection

If unpleasant symptoms appear, you should visit a gynecologist, urologist or venereologist. Diagnosis of sexually transmitted diseases includes taking a smear from the vagina, urethra, cervical, urethra, PCR, clinical blood and urine tests.

Based on the results obtained, the doctor selects drugs that can destroy all types of pathogenic microorganisms.

If treatment is not started in a timely manner, men develop urethritis, prostatitis due to sexually transmitted infections, decreased libido, and possible infertility.

The inflammatory process covers the testicles and seminal vesicles. In women, trichomoniasis and chlamydia can cause adhesions and inability to conceive. Pathogenic microorganisms can cause miscarriage or premature birth during pregnancy.

How to expel chlamydia?

Antibacterial drugs are used to treat chlamydia; in order for the therapy to be effective, it is necessary to first test the sensitivity of microorganisms to the active substance of the drug.

The drug of choice for the treatment of chlamydia is often Doxycycline from the tetracycline group. Despite long-term use of this medicine, pathogenic microorganisms have not developed immunity to it. Dosage regimen: on day 1, 200 mg in the morning and evening, then 100 mg twice a day.

Azithromycin (Sumamed) helps to cope well with chlamydia - on day 1 you need to take 500 mg of the medicine in the morning and evening, then 500 mg once a day every other day for a week.

How to treat chlamydia:

• macrolides – Clarithromycin, Fromilid, 500 mg twice a day for 7 days;
• rifamycins – Rifampicin;
• fluoroquinols – Ciprofloxacin, Ciprobay, Ofloxacin;
• antimycotic drugs - Flucostat, 50 mg once a day for a week;
• suppositories - Hexicon, Vagilak, administered anally or vaginally;
• means for restoring microflora - Linex, Hilak-Forte;
• local preparations – Erythromycin, Tetracycline ointment.

The average duration of treatment for chlamydia is 1–2 weeks. Additionally, immunomodulators and vitamin complexes are prescribed.

When treating chlamydia in pregnant women, Erythromycin is used - 500 mg once every 6 hours for a week, or 250 mg four times a day for 2 weeks. The same drug is also used to treat children - the dosage is 50 mg/kg. Reception should be continued for 10–14 days.

In case of chronic chlamydia, before starting antibacterial therapy, a course of Polyoxidonium injections is first administered or Interferon is prescribed to strengthen the patient’s immunity.

Reliable ways to get rid of Trichomonas

The main drug for the treatment of trichomoniasis is Metronidazole and its derivatives. The medicine is available in the form of tablets and vaginal suppositories, which allows you to effectively treat the infection in women and men. Duration of treatment is 7–14 days.

Tinidazole, Ornidazole, Macmiror, and antibiotics from the tetracycline group are used as additional drugs.

Is it possible to treat sexually transmitted diseases with folk remedies?

Alternative medicine methods will not help get rid of chlamydia and trichomonas, but they can enhance the therapeutic effect of medications and speed up the recovery process.

One of the effective methods of combating sexually transmitted infections is douching with garlic tincture. Pour 500 ml of alcohol into 50% chopped garlic, place in a dark place for 14 days, shake daily.

Strain the resulting tincture and dilute it with water in a ratio of 1:10 before the procedure. One session will require 300 ml of solution.

Juice therapy also helps well - add 60 ml of fresh beetroot and cranberry juice to 120 ml of blackcurrant juice. Drink the drink in the morning and evening after meals for a month. This treatment method helps strengthen the immune system and is effective for chronic infections.

Prevention of STDs

To avoid infection with sexually transmitted diseases, you must be careful when choosing a sexual partner, use barrier contraception, and do not use other people’s underwear, washcloths, or towels.

A story from a qualified specialist about the treatment of combined STIs:

Strict adherence to the rules of personal hygiene is the basic rule for preventing various sexually transmitted infections.

Prevention of sexually transmitted diseases involves regular visits to the doctor; partners should undergo all necessary tests at the stage of pregnancy planning to avoid miscarriage, premature birth, and infection of the fetus.

Trichomoniasis and chlamydia are dangerous sexually transmitted diseases that negatively affect the functioning of the genitourinary and reproductive systems. Is it possible to cure the diseases forever?

Alternative opinion. While visiting Dr. Komarovsky, obstetrician-gynecologist Sergei Baksheev talks about commercial diagnoses in gynecology, among which he names chlamydia:

With timely diagnosis and proper therapy, you can get rid of pathologies without consequences and complications in 2 weeks. If the infectious process is started, it will become chronic and require long-term and not always successful treatment.

Antibiotic therapy for chlamydia infection is the main, and sometimes the only, direction of treatment. When choosing antibiotics for chlamydia, it is taken into account which organs require treatment for chlamydia. Even in the treatment of urogenital chlamydial infection, therapy differs depending on the form and predominant localization of urogenital chlamydia (with damage to the lower or upper parts of the genitourinary system, or persistent, recurrent in the genitourinary system).

3 main groups of drugs are used in the treatment of chlamydia

In addition, the severity of the disease, its duration, whether antibiotics were used previously and which ones, whether treatment with them was successful, concomitant pathologies, the patient’s age, the presence of pregnancy in women, and the likelihood of persistent infection are important. Given the complexity of the choice, it must be carried out by a specialist.

Antibiotic therapy for urogenital chlamydia

Lower parts of the genitourinary system. Therapy for chlamydia of this localization in men and women is often limited to antibiotics and does not require additional drugs. Antibiotics from the tetracycline and macrolide groups are used for this purpose.

Tetracycline antibiotics are predominantly prescribed. Doxycycline is recognized as the most effective. It is found effective in the treatment of urogenital chlamydia in both men and women: 95–100%. At the same time, a pleasant plus is the low cost of treatment.

Doxycycline and Solutab can be used for various infections in the genitourinary system.

Compared to other antibiotics in this group, Doxycycline has high bioavailability; it remains in the body longer than others (it requires taking a small amount). In addition, it is better tolerated by patients. When using it, there is no need to follow a diet.

Treatment with tetracyclines should be discontinued if there are symptoms of renal failure. They are contraindicated for pregnant women, as well as for women during breastfeeding and children under 8 years of age.

Side effects of treatment with drugs of this group are rare. Among them, the most common symptoms are nausea, vomiting is possible, and allergic reactions occur.

Tetracycline antibiotics - classification

Tetracycline antibiotics for chlamydia are not prescribed to patients with concomitant renal failure or for the treatment of pregnant women. Sunbathing is not recommended while taking these medications. It has been noted that when using Doxycycline monohydrate, its side effects are less pronounced than those of Doxycycline hydrochloride.

Pharmacies sell doxycycline monohydrate in Unidox Solutab tablets. This form is unique in its own way. The tablets can be drunk whole, divided or chewed. You can even dissolve them to form a syrup (in 20 ml of water) or a solution (in 100 ml of water). Its bioavailability is more than 95%. This parameter equates the effectiveness of the drug orally with its intravenous administration. As a rule, Doxycycline is prescribed 100 mg twice a day for 7 days. First dose 200 mg.
An alternative is to take Tetracycline 500 mg four times for 7-10 days or Metacycline 300 mg twice a day.

Macrolides are popular in the fight against chlamydia. The main one in this group is Azithromycin. It has a long half-life and high absorption. The drug is not subject to the destructive effects of the acidic contents of the stomach. It is transported by leukocytes directly to the site of inflammation and has the ability to penetrate cells. Modern macrolides have fewer side effects. However, in 2-4% of cases they occur. Possible nausea, vomiting, diarrhea, jaundice, short-term changes in liver transaminases, allergies.

Azithromycin is most often prescribed for a single dose before meals 1 hour or after meals 2 hours. Josamycin - 500 mg twice a day for 10 days. An alternative is Erythromycin, Roxithromycin, Spiramycin, Clarithromycin.

The group of fluoroquinolones also has antichlamydial activity to varying degrees. They are used as alternative drugs. For example, Ofloxacin, Levofloxacin. The advantage of Ofloxacin among the drugs in its group is its complete absorption into the blood.

Priority in the fight against chlamydia is not given to this drug because after its treatment a higher percentage of relapses is determined.

Drugs - Ofloxacin and Levofloxacin

However, they are used to treat mixed gonorrheal-chlamydial infection. They are not prescribed to pregnant women, children under 12 years of age, and patients with concomitant severe liver and kidney diseases. Side effects include nausea, vomiting, dizziness, and allergies. For chlamydia, the following fluoroquinolones are prescribed: Ofloxacin, Levofloxacin

Chlamydia of the upper urogenital tract. Treatment of these departments is carried out with similar drugs, but longer: 3-4 weeks.

Persistent urogenital chlamydia. Treatment of patients with this form of the disease requires not only conventional antibacterial therapy. The persistent form involves the presence of chlamydia, which freezes in its development for a certain period. And generally accepted antibiotics destroy bacteria that multiply and exhibit vital activity.

Treatment of respiratory chlamydia

The principles of treatment for respiratory chlamydia differ from those for its urogenital form. Drugs from the macrolide and fluoroquinolone groups are considered relevant.

Macrolides accumulate in areas of inflammation. This actively occurs in the parenchymal tissue of the tonsils, lymph nodes, lung structures, pleural fluid, pelvic organs, and joint structures. Therefore, they are effective in the treatment of respiratory chlamydia.

Erythromycin, Oleandomycin, Clarithromycin, Roxithromycin, Azithromycin, Josamycin, Spiramycin, Midecamycin are popular. Side effects caused by macrolide antibiotics are rare. Allergic reactions occur in 0–5% of children.

Treatment of chlamydia in pregnant women

There are insufficient data on the effects of antichlamydial drugs in pregnant women and infants. This is explained by the fact that such studies have not been carried out in full for these categories for obvious reasons. This also applies to new drugs.

Today, Erythromycin, Spiramycin, and Josamycin are considered safe for the treatment of chlamydia in pregnant women.

Urogenital chlamydia is one of the most common sexually transmitted infections

It is Josamycin that is approved in Russia for the treatment of pregnant women. An alternative is Azithromycin, Amoxicillin. Some European countries today recognize Azithromycin as an antibiotic for the treatment of pregnant women.

Although Amoxicillin, a penicillin, is generally not recommended for the treatment of chlamydia, it has been shown to be an effective antibiotic in the fight against chlamydia in pregnant women.

Thus, in the treatment of chlamydia, antibacterial drugs of the macrolide, tetracycline, and fluoroquinolone groups are used. The specific choice depends on many factors, therefore it is prescribed by a specialist after diagnosing the localization of chlamydia in the body and its type.