Comparison of gastrointestinal side effects from different doses of azithromycin for the treatment of gonorrhoea.

Abstract

OBJECTIVES:

Azithromycin is commonly used to treat Neisseria gonorrhoeae. We compared its gastrointestinal side effects using 1 g single, 2 g single or 2 g split (i.e. 1 g plus 1 g 6-12 h later) dosing, representing our clinic's changing guidelines over the study period.

METHODS:

We recruited consecutive sexual health clinic patients who received azithromycin (and 500 mg ceftriaxone) for uncomplicated gonorrhoea. Each patient received a text message 48 h after their attendance to complete a questionnaire.

RESULTS:

Patients received 1 g single (n = 271), 2 g single (218) or 2 g split (105) doses. Vomiting was less common for 1 g versus 2 g single dose [1.1% versus 3.7%; risk difference (RD): -2.6%; 95% CI: -0.2 to -5.4] and 2 g split versus 2 g single dose (0.9% versus 3.7%; RD: -2.8%; 95% CI: -0.3 to -5.8). Nausea was less common for 1 g versus 2 g single dose (13.7% versus 43.1%; RD: -29.5%; 95% CI: -21.7 to -37.2) and 2 g split versus 2 g single dose (16.4% versus 43.1%; RD: -26.8; 95% CI: -17.2 to -36.3). Diarrhoea was less common for 1 g versus 2 g single dose (25.5% versus 50.9%; RD: -25.5%; 95% CI: -17.0 to -33.9) and 2 g split versus 2 g single dose (30.9% versus 50.9%; RD: -20.0; 95% CI: -9.1 to -30.9). Almost all were willing to retake the same dosing for gonorrhoea in the future: 97% for 1 g single; 94% for 2 g single; and 97% for 2 g split dose.

CONCLUSIONS:

Azithromycin 2 g split dose for gonorrhoea resulted in significantly less vomiting, nausea and diarrhoea than a 2 g single dose.

• Authors: Jason J Ong, Ivette Aguirre, Magnus Unemo, Fabian Y S Kong, Christopher K Fairley, Jane S Hocking, Eric P F Chow, Warittha Tieosapjaroen, Jenny Ly, Marcus Y Chen
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 77 Issue 7 Pg. 2011-2016 (06 29 2022) ISSN: 1460-2091 [Electronic] England
• PMID: 35411400 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.

Chemical References

• Anti-Bacterial Agents
• Ceftriaxone
• Azithromycin

Topics

• Anti-Bacterial Agents (adverse effects)
• Azithromycin (adverse effects)
• Ceftriaxone (therapeutic use)
• Diarrhea (drug therapy)
• Drug-Related Side Effects and Adverse Reactions
• Gonorrhea (drug therapy)
• Humans
• Nausea (chemically induced, drug therapy)
• Neisseria gonorrhoeae
• Vomiting (chemically induced, drug therapy)