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October 27, 1993

Azithromycin in Chlamydial Urethritis

JAMA. 1993;270(16):1934-1935. doi:10.1001/jama.1993.03510160052025

To the Editor.  —A single 1-g dose of azithromycin has recently demonstrated effectiveness in treating uncomplicated genital chlamydial infection.1 As such, azithromycin represents a major advance in the treatment of chlamydial infection and may improve our efforts to limit the spread of this important pathogen. In view of the proven efficacy of the 1-g regimen, we examined whether a lower dose (500 mg) might be as effective in treating chlamydial infection. A lower dose would cost less and might be associated with fewer side effects. Since the mean tissue concentration after a 500-mg dose of azithromycin ranges between 1 and 9 mg/kg, with levels remaining above 1 mg/kg for 2 to 3 days,2 the expected tissue levels exceed the 90% minimum inhibitory concentration of Chlamydia trachomatis (0.25 mg/L) for at least several days.3Eleven men with nongonococcal urethritis, characterized by urethral discharge, microscopic leukocytosis, and positive rapid