Chlamydia trachomatis is the most frequent sexually transmitted bacterial pathogen in developed countries [3, 12, 13]. The position is similar in the Czech Republic. Depending on the group of examined women active
Chlamydia infection varies between 10 and 23%. The increasing incidence of urogenital
Chlamydia infections and improving diagnostic possibilities call for adequate treatment. Correct treatment of urogenital
infections caused by Chlamydia trachomatis is very important for the prevention of undesirable sequelae of
inflammations of the lesser pelvis, subsequent risk of GEU,
sterility, prevention of premature delivery and possible
infection of the neonate. When starting treatment, selecting a suitable
antibiotic and deciding on the therapeutic strategy it is important to select an
antibiotic with regard to its efficacy, the epidemiological situation, regional sensitivity of the infectious agent, toxicity and tolerance of the
antibiotic, to its bacteriostatic or bactericide action, and last not least, also its price. Despite selection of a suitable
antibiotic sometimes treatment fails. For treatment of urogenital chlamydial
infections tetracyclin and macrolid
antibiotics are recommended or
quinolone chemotherapeutic agents of the third generation.
Tetracyclines are broad spectrum
antibiotics with bacteriostatic action. As to oral forms
doxycycline,
tetracycline and
oxytetracycline are used. The most frequent undesirable effects during treatment are
nausea,
vomiting, diarrhoea and
abdominal pain.
Tetracycline antibiotics are contraindicated in children under 8 years, during pregnancy and lactation and in case of sensitivity to this group of drugs. Macrolids are
antibiotics with a medium broad antibacterial spectrum with bacteriostatic action. Macrolids of the first generation have a low antibacterial activity. They have a short
biological half-life, not always a good tolerance, and serious clinically important drug interactions may develop. The most frequently used preparations of the first generation include
erythromycin, josamycina and
spiramycin. Macrolids of the second generation, azitromycin, roxitromycin and claritromycin lack the above negative properties. The most frequent undesirable effects after administration of macrolids include
nausea and
vomiting. Considerable differences were found in particular between different preparations containing
erythromycin. Macrolids of the second generation have only slight undesirable gastrointestinal effects. Macrolid
antibiotics are contraindicated in case of sensitization to this group, in severe hepatic disorders and great care must be taken in the treatment of pregnant women.
Quinolone chemotherapeutic agents of the third generation, ciprofloxacine, enoxacine,
ofloxacine and
pefloxacine are
synthetic drugs with a broad antibacterial spectrum which act on systemic
infections. On
oral administration they are rapidly absorbed and the blood and tissue concentrations are sufficiently effective. In the treatment of urogenital
Chlamydia infections they are useful in the treatment of
chronic infections after failure of previous macrolid and
tetracycline therapy. The most frequent undesirable side-effects include
nausea,
vomiting, meteorism, diarrhoea,
tinnitus,
headache, changes of mood, allergic skin reaction. They are contraindicated in
hypersensitivity to
quinolone chemotherapeutic preparations, in children and adolescents under 18 years, during pregnancy and lactation. The objective of the present study was to evaluate different therapeutic patterns, their efficacy and tolerance.