Efficacy of azithromycin versus doxycycline in the treatment of genital Chlamydia trachomatis infection: a meta-analysis

Abstract

Objective To systematically evaluate the efficacy of azithromycin and doxycycline in the treatment of genital Chlamydia trachomatis infection. Methods Databases including Cochrane library, PubMed, EMBASE, CBMdisc, CNKI and Wanfang were searched from January 1, 1980 to October 2017 for randomized controlled trials (RCTs) comparing the efficacy of azithromycin versus doxycycline in the treatment of genital Chlamydia trachomatis infection. In these RCTs, negative microbiological findings were defined as cure. Patients in the treatment group were treated with azithromycin, and those in the control group were treated with doxycycline. Two researchers independently extracted data and evaluated the quality of these RCTs. Statistical analysis was done by using Stata 12.0 software. Results A total of 24 research reports were enrolled, including 24 RCTs and 2 369 patients. There were 1 302 patients in the azithromycin group and 1 067 in the doxycycline group. Meta-analysis showed that there was a significant difference in the microbiological response rate between the treatment group and the control group. A fixed-effect model was used to combine the response rate, and showed that the response rate to doxycycline was superior to that to azithromycin, with a risk difference of 2.8% (95% CI, 0.9%-4.6%) . Conclusion The microbiological response rate to azithromycin is lower than that to doxycycline in the treatment of genital Chlamydia trachomatis infection, but more RCTs are required to confirm the clinical efficacy of doxycycline. Key words: Chlamydia trachomatis; Azithromycin; Doxycycline; Treatment outcome; Meta-analysis