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
Workowski KA, Johnson RB, Verdon M, Stamm WE. Azithromycin in Chlamydial Urethritis. JAMA. 1993;270(16):1934–1935. doi:10.1001/jama.1993.03510160052025
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