Erythromycin for persistent or recurrent nongonococcal urethritis. A randomized, placebo-controlled trial.

Abstract

OBJECTIVE:

To evaluate the efficacy of a 3-week regimen of erythromycin for treatment of persistent or recurrent nongonococcal urethritis in men.

DESIGN:

A prospective, randomized, double-blind trial with follow-up at 2, 4, and 8 weeks after enrollment.

PATIENTS:

Seventy-seven evaluable men with objective evidence of nongonococcal urethritis (36 in the erythromycin group and 41 in the placebo group) with a mean age of 28 years, a median duration of urethritis of 3 months, and a median number of three previous antimicrobial regimens.

INTERVENTION:

Erythromycin, 500 mg, or placebo four times daily for 3 weeks.

RESULTS:

After 2 weeks of treatment, urethral symptoms resolved in 13 of 25 erythromycin-treated patients compared with 8 of 34 placebo-treated patients (P = 0.03). Erythromycin also resulted in more frequent resolution of urethral discharge and leukocytosis at all visits compared with placebo but these differences were not statistically significant. First-voided urine leukocyte counts decreased, however, by a median of 89% (95% CI, -96% to -67%) in the erythromycin group compared with 23% (CI, -73% to 83%) in the placebo group after treatment (P = 0.02 for the difference in changes). Further, in men with prostatic inflammation, urinary leukocyte counts decreased by a median of 94% (CI, -99% to -83%) after treatment in erythromycin-treated patients compared with a 46% increase (CI, -57% to 290%) in placebo-treated patients (P = 0.0003 for the difference in changes).

CONCLUSION:

A 3-week regimen of erythromycin was more effective than placebo in improving symptoms and in reducing pyuria in men with persistent or recurrent nongonococcal urethritis, especially among men with prostatic inflammation.

• Authors: T M Hooton, E S Wong, R C Barnes, P L Roberts, W E Stamm
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 113 Issue 1 Pg. 21-6 (Jul 01 1990) ISSN: 0003-4819 [Print] United States
• PMID: 2190516 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Erythromycin

Topics

• Adult
• Chronic Disease
• Confidence Intervals
• Double-Blind Method
• Erythromycin (adverse effects, therapeutic use)
• Humans
• Leukocyte Count (drug effects)
• Male
• Prostatitis (drug therapy)
• Randomized Controlled Trials as Topic
• Recurrence
• Sexually Transmitted Diseases, Bacterial (drug therapy)
• Urethritis (drug therapy, microbiology, urine)