Азитромицин является препаратом выбора для лечения неосложненной урогенитальной хламиийной инфекции у женщин и занимает важное место в терапии воспалительных заболеваний органов малого таза. Некоторые эксперты прогнозируют его революционную роль в лечении заболеваний, передающихся половых путем, в целом, поскольку, наряду с C. trachomatis и N. gonorrhoeae, азитромицин проявляет активность и в отношении других важных возбудителей, включая Haemophilus ducreyi и Treponema pallidum.
Azithromycin is the drug of choice for management of uncomplicated urogenital chlamydial infection in women and begins to gain its’ niche in management of pelvic inflammatory diseases. Some experts predict its revolutionary role in the treatment of sexually transmitted diseases infections in general, since, along with C. trachomatis and N. gonorrhoeae, azithromycin is active against other important pathogens, including Haemophilus ducreyi and Treponema pallidum.
1. Савельева Г.М., Антонова Л.В. Острые воспалительные заболевания внутренних половых органов женщин. М., 1987.
2. Washington AE, Katz P. Cost of and payment source for pelvic inflammatory disease. Trends and projections, 1983 through 2000. JAMA 1991; 266: 2565.
3. Workowski K, Berman S. Sexually Transmitted Diseases Treatment Guidelines, 2010. Morbidity and Mortality Weekly: Recommendations and Reports. 59 (RR12): 1–110.
4. Pletcher J, Slap G. Pelvic inflammatory disease. Pediatr Rev 1998; 19: 363–67.
5. Soper DE. Pelvic inflammatory disease. Obstet Gynecol 2010; 116: 419.
6. Westrom L, Eschenbach D. Pelvic inflammatory disease. In: Holms KK, Mardh P, Sparling PF et al. Eds Sexually Transmitted Diseases, 3rd edn. New York, USA, McGraw Publishers, 1999; 58: 783–810.
7. Workowski KA, Berman S. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines. MMWR Recom Rep 2010; 59 (RR-12): 1–110.
8. Hillis SD, Owens LM, Marchbanks PA et al. Recurrent chlamydial infections increase the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease. Am J Obstet Gynecol 1997; 176: 103–07.
9. Eissa MAH, Cromwell PF. Diagnosis and Management of Pelvic Inflammatory Disease in Adolescents. J Pediatr Health Care 2003; 17: 145–7.
10. Soper DE, Brockwell NJ, Dalton HP, Johnson D. Observations concerning the microbial etiology of acute salpingitis. Am J Obstet Gynecol 1994; 170:1008.
11. Ness RB, Kip KE, Hillier SL et al. A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease. Am J Epidemiol 2005; 162: 585.
12. Сanadian Guidelines on Sexually Transmitted Infections (with current updates and errata), January 2010. http://www.phac-aspc.gc.ca/std-mts/sti-its/guide-lignesdir-eng.php
13. Ross JDC, Cronje S, Paszkowski T et al. Moxifloxacin versus ofloxacin plus metronidazole in uncomplicated pelvic inflammatory disease: results of a multicentre, double blind, randomised trial. Sex Transm Infect 2006; 82: 446–51.
14. Nori S, Nebesio C, Brashear R, Travers JB. Moxifloxacin-associated drug hypersensitivity syndrome with toxic epidermal necrolysis and fulminant hepatic failure. Arch Dermatol 2004; 140: 1537–8.
15. Soto S, López-Rosés L, Avila S et al. Moxifloxacin-induced acute liver injury. Am J Gastroenterol 2002; 97: 1853–4.
16. Important information regarding serious adverse reactions and safety measures Direct Healthcare Professional Communication regarding moxifloxacin (Avelox®) and serious hepatic and bullous skin reactions February 2008 http://www.mhra.gov.uk/home/groups/pl-p/documents/websiteresources/con014103.pdf
17. Updated Labeling for Antibiotic Avelox (Moxifloxacin) Regarding Rare Risk of Severe Liver Injury Information Update:http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2010/2010_42-eng.php
18. ESSTI, Euro-GASP 2006&2007 summary report of N. gonorrhoeae antimicrobial susceptibility surveillance results 2007.
19. Clinical Effectiveness Group, British Association for Sexual Health and HIV. UK National Guideline for the management of Pelvic Inflammatory Disease 2011. www.bashh.org
20. Федеральное государственное учреждение «Центральный научно-исследовательский кожно-венерологический институт» Росздрава. Информационный бюллетень по состоянию резистентности гонококка к антибактериальным препаратам. Москва, 2006.
21. Резистентность возбудителей ИППП к антибактериальным препаратам. Информационный бюллетень, 2008. М.: ООО «ДЭКС-ПРЕСС», 2008.
22. Kubanova A, Frigo N, Kubanov A et al. The Russian gonococcal antimicrobial susceptibility programme (RU-GASP) – national resistance prevalence in 2007 and 2008, and trends during 2005–2008. Euro Surveill 2010; 15 (14): pii 19533.
23. Shih TY, Gaydos CA, Rothman RE, Hsieh YH. Poor Provider Adherence to the Centers for Disease Control and Prevention Treatment Guidelines in US Emergency Department Visits With a Diagnosis of Pelvic Inflammatory Disease. Sex Transm Dis. 2011 Feb 10. [Epub. ahead of print].
24. Horner P. The case for further treatment studies of uncomplicated genital Chlamydia trachomatis infection. Sex Transm Infect 2006; 82 (4): 340–3.
25. Martin DH, Mroczdowski TF, Dalu Z et al. A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. N Engl J Med 1992; 327: 921–5.
26. Thorpe EM, Stamm WE, Hook EW et al. Chlamydial cervicitis and urethritis: single dose treatment compared with doxycycline for seven days in community based practises. Genitourin Med 1996; 72: 93–7.
27. Nilsen A, Halsos A, Johansen A et al. A double blind study of single dose azithromycin and doxycycline in the treatment of chlamydial urethritis in males. Genitourin Med 1992; 68: 325–7.
28. Weber JT, Johnson RE. New treatments for Chlamydia trachomatis genital infection. Clin Infect Dis 1995; 20 (Suppl. 1):66–71.
29. Adair CD, Gunter M, Stovall TG et al. Chlamydia in pregnancy: a randomized trial of azithromycin and erythromycin. Obstet Gynecol 1998; 91 (2): 165–8.
30. Lau CY, Qureshi AK. Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials. Sex Transm Dis 2002; 29: 497.
31. Worm AM, Osterling A. Azithromycin levels in cervical mucous and plasma after a single oral dose. In: The 2nd International Conference on the Macrolides, Azalides and Streptogramins. Venice, 1994; abstr. 200.
32. Национальный стандарт «Хламидийная инфекция. Неосложненная форма» (проект). Врач. спец. вып. 2008; 5–26.
33. Российское общество дерматовенерологов. Инфекции, передаваемые половым путем. Хламидийная инфекция. Клинические рекомендации. Дерматовенерология. Под ред. А.А.Кубановой. М.: ДЭКС-Пресс, 2008; 349–66.
34. Клинические рекомендации. Акушерство и гинекология. Под ред. Г.М.Савельевой, В.Н.Серова, Г.Т.Сухих. М.: ГЭОТАР-Медиа, 2009; 703–10.
35. World Health Organization. Guidelines for the management of sexually transmitted infections http://www.who.int/hiv/pub/sti/en/STIGuidelines2003.pdf
36. PID Treatment Guidelines – Europe 2006 v5 – 2008 minor update. dochttp://www.iusti.org/regions/europe/PID_v5.pd
37. Källén BA, Otterblad Olausson P, Danielsson BR. Is erythromycin therapy teratogenic in humans? Reprod Toxicol 2005; 20 (2): 209–14.
38. Lanjouw E, Ossewaarde JM, Stary A, Boag F. European guideline for the management of Chlamydia trachomatis infections. July 2010 http://www.iusti.org/regions/europe/Euro_Guideline_Chlamydia_2010.pdf
39. Sendag F, Terek C, Tuncay G et al. Single dose oral azithromycin versus seven day doxycycline in the treatment of non-gonococcal mucopurulent endocervicitis. Aust N Z J Obstet Gynaecol 2000; 40 (1): 44–7.
40. Handsfield HH, Dalu ZA, Martin DH et al. Multicenter trial of single-dose azithromycin vs. ceftriaxone in the treatment of uncomplicated gonorrhea. Azithromycin Gonorrhea Study Group. Sex Transm Dis 1994; 21 (2): 107–11.
41. Guven MA, Gunyeli I, Dogan M et al. The demographic and behavioural profile of women with cervicitis infected with Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum and the comparison of two medical regimens. Arch Gynecol Obstet 2005; 272 (3): 197–200.
42. Björnelius E, Anagrius C, Bojs G et al. Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: a controlled clinical trial. Sex Transm Infect 2008; 84 (1): 72–6.
43. Savaris RF, Teixeira LM, Torres TG et al. Comparing ceftriaxone plus azithromycin or doxycycline for pelvic inflammatory disease: a randomized controlled trial. Obstet Gynecol 2007; 110 (1): 53–60.
44. Bevan CD, Ridgway GL, Rothermel CD. Efficacy and safety of azithromycin as monotherapy or combined with metronidazole compared with two standard multidrug regimens for the treatment of acute pelvic inflammatory disease. J Int Med Res 2003; 31 (1): 45–54.
45. Malhotra M, Sharma JB, Batra S et al. Ciprofloxacin-tinidazole combination, fluconazole-azithromicin-secnidazole-kit and doxycycline-metronidazole combination therapy in syndromic management of pelvic inflammatory disease: a prospective randomized controlled trial. Indian J Med Sci 2003; 57 (12): 549–55.
46. Brookoff D. Compliance with doxycycline therapy for outpatient treatment of pelvic inflammatory disease. South Med J 1994; 87 (11): 1088–91.
47. Haggerty CL, F Totten PA, Astete SG et al. Failure of cefoxitin and doxycycline to eradicate endometrial Mycoplasma genitalium and the consequence for clinical cure of pelvic inflammatory disease. Sex Transm Infect 2008; 84 (5): 338–42.
48. WA Health. Guidelines for Managing Sexually Transmitted Infections http://silverbook.health.wa.gov.au/Default.asp?PublicationID=1&ParentSectionID=P1&Se...
49. Rustomjee R, Kharsany AB, Connolly CA, Karim SS. A randomized controlled trial of azithromycin versus doxycycline/ciprofloxacin for the syndromic management of sexually transmitted infections in a resource-poor setting. J Antimicrob Chemother 2002; 49 (5): 875–8.
________________________________________________
1. Савельева Г.М., Антонова Л.В. Острые воспалительные заболевания внутренних половых органов женщин. М., 1987.
2. Washington AE, Katz P. Cost of and payment source for pelvic inflammatory disease. Trends and projections, 1983 through 2000. JAMA 1991; 266: 2565.
3. Workowski K, Berman S. Sexually Transmitted Diseases Treatment Guidelines, 2010. Morbidity and Mortality Weekly: Recommendations and Reports. 59 (RR12): 1–110.
4. Pletcher J, Slap G. Pelvic inflammatory disease. Pediatr Rev 1998; 19: 363–67.
5. Soper DE. Pelvic inflammatory disease. Obstet Gynecol 2010; 116: 419.
6. Westrom L, Eschenbach D. Pelvic inflammatory disease. In: Holms KK, Mardh P, Sparling PF et al. Eds Sexually Transmitted Diseases, 3rd edn. New York, USA, McGraw Publishers, 1999; 58: 783–810.
7. Workowski KA, Berman S. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines. MMWR Recom Rep 2010; 59 (RR-12): 1–110.
8. Hillis SD, Owens LM, Marchbanks PA et al. Recurrent chlamydial infections increase the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease. Am J Obstet Gynecol 1997; 176: 103–07.
9. Eissa MAH, Cromwell PF. Diagnosis and Management of Pelvic Inflammatory Disease in Adolescents. J Pediatr Health Care 2003; 17: 145–7.
10. Soper DE, Brockwell NJ, Dalton HP, Johnson D. Observations concerning the microbial etiology of acute salpingitis. Am J Obstet Gynecol 1994; 170:1008.
11. Ness RB, Kip KE, Hillier SL et al. A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease. Am J Epidemiol 2005; 162: 585.
12. Сanadian Guidelines on Sexually Transmitted Infections (with current updates and errata), January 2010. http://www.phac-aspc.gc.ca/std-mts/sti-its/guide-lignesdir-eng.php
13. Ross JDC, Cronje S, Paszkowski T et al. Moxifloxacin versus ofloxacin plus metronidazole in uncomplicated pelvic inflammatory disease: results of a multicentre, double blind, randomised trial. Sex Transm Infect 2006; 82: 446–51.
14. Nori S, Nebesio C, Brashear R, Travers JB. Moxifloxacin-associated drug hypersensitivity syndrome with toxic epidermal necrolysis and fulminant hepatic failure. Arch Dermatol 2004; 140: 1537–8.
15. Soto S, López-Rosés L, Avila S et al. Moxifloxacin-induced acute liver injury. Am J Gastroenterol 2002; 97: 1853–4.
16. Important information regarding serious adverse reactions and safety measures Direct Healthcare Professional Communication regarding moxifloxacin (Avelox®) and serious hepatic and bullous skin reactions February 2008 http://www.mhra.gov.uk/home/groups/pl-p/documents/websiteresources/con014103.pdf
17. Updated Labeling for Antibiotic Avelox (Moxifloxacin) Regarding Rare Risk of Severe Liver Injury Information Update:http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2010/2010_42-eng.php
18. ESSTI, Euro-GASP 2006&2007 summary report of N. gonorrhoeae antimicrobial susceptibility surveillance results 2007.
19. Clinical Effectiveness Group, British Association for Sexual Health and HIV. UK National Guideline for the management of Pelvic Inflammatory Disease 2011. www.bashh.org
20. Федеральное государственное учреждение «Центральный научно-исследовательский кожно-венерологический институт» Росздрава. Информационный бюллетень по состоянию резистентности гонококка к антибактериальным препаратам. Москва, 2006.
21. Резистентность возбудителей ИППП к антибактериальным препаратам. Информационный бюллетень, 2008. М.: ООО «ДЭКС-ПРЕСС», 2008.
22. Kubanova A, Frigo N, Kubanov A et al. The Russian gonococcal antimicrobial susceptibility programme (RU-GASP) – national resistance prevalence in 2007 and 2008, and trends during 2005–2008. Euro Surveill 2010; 15 (14): pii 19533.
23. Shih TY, Gaydos CA, Rothman RE, Hsieh YH. Poor Provider Adherence to the Centers for Disease Control and Prevention Treatment Guidelines in US Emergency Department Visits With a Diagnosis of Pelvic Inflammatory Disease. Sex Transm Dis. 2011 Feb 10. [Epub. ahead of print].
24. Horner P. The case for further treatment studies of uncomplicated genital Chlamydia trachomatis infection. Sex Transm Infect 2006; 82 (4): 340–3.
25. Martin DH, Mroczdowski TF, Dalu Z et al. A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. N Engl J Med 1992; 327: 921–5.
26. Thorpe EM, Stamm WE, Hook EW et al. Chlamydial cervicitis and urethritis: single dose treatment compared with doxycycline for seven days in community based practises. Genitourin Med 1996; 72: 93–7.
27. Nilsen A, Halsos A, Johansen A et al. A double blind study of single dose azithromycin and doxycycline in the treatment of chlamydial urethritis in males. Genitourin Med 1992; 68: 325–7.
28. Weber JT, Johnson RE. New treatments for Chlamydia trachomatis genital infection. Clin Infect Dis 1995; 20 (Suppl. 1):66–71.
29. Adair CD, Gunter M, Stovall TG et al. Chlamydia in pregnancy: a randomized trial of azithromycin and erythromycin. Obstet Gynecol 1998; 91 (2): 165–8.
30. Lau CY, Qureshi AK. Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials. Sex Transm Dis 2002; 29: 497.
31. Worm AM, Osterling A. Azithromycin levels in cervical mucous and plasma after a single oral dose. In: The 2nd International Conference on the Macrolides, Azalides and Streptogramins. Venice, 1994; abstr. 200.
32. Национальный стандарт «Хламидийная инфекция. Неосложненная форма» (проект). Врач. спец. вып. 2008; 5–26.
33. Российское общество дерматовенерологов. Инфекции, передаваемые половым путем. Хламидийная инфекция. Клинические рекомендации. Дерматовенерология. Под ред. А.А.Кубановой. М.: ДЭКС-Пресс, 2008; 349–66.
34. Клинические рекомендации. Акушерство и гинекология. Под ред. Г.М.Савельевой, В.Н.Серова, Г.Т.Сухих. М.: ГЭОТАР-Медиа, 2009; 703–10.
35. World Health Organization. Guidelines for the management of sexually transmitted infections http://www.who.int/hiv/pub/sti/en/STIGuidelines2003.pdf
36. PID Treatment Guidelines – Europe 2006 v5 – 2008 minor update. dochttp://www.iusti.org/regions/europe/PID_v5.pd
37. Källén BA, Otterblad Olausson P, Danielsson BR. Is erythromycin therapy teratogenic in humans? Reprod Toxicol 2005; 20 (2): 209–14.
38. Lanjouw E, Ossewaarde JM, Stary A, Boag F. European guideline for the management of Chlamydia trachomatis infections. July 2010 http://www.iusti.org/regions/europe/Euro_Guideline_Chlamydia_2010.pdf
39. Sendag F, Terek C, Tuncay G et al. Single dose oral azithromycin versus seven day doxycycline in the treatment of non-gonococcal mucopurulent endocervicitis. Aust N Z J Obstet Gynaecol 2000; 40 (1): 44–7.
40. Handsfield HH, Dalu ZA, Martin DH et al. Multicenter trial of single-dose azithromycin vs. ceftriaxone in the treatment of uncomplicated gonorrhea. Azithromycin Gonorrhea Study Group. Sex Transm Dis 1994; 21 (2): 107–11.
41. Guven MA, Gunyeli I, Dogan M et al. The demographic and behavioural profile of women with cervicitis infected with Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum and the comparison of two medical regimens. Arch Gynecol Obstet 2005; 272 (3): 197–200.
42. Björnelius E, Anagrius C, Bojs G et al. Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: a controlled clinical trial. Sex Transm Infect 2008; 84 (1): 72–6.
43. Savaris RF, Teixeira LM, Torres TG et al. Comparing ceftriaxone plus azithromycin or doxycycline for pelvic inflammatory disease: a randomized controlled trial. Obstet Gynecol 2007; 110 (1): 53–60.
44. Bevan CD, Ridgway GL, Rothermel CD. Efficacy and safety of azithromycin as monotherapy or combined with metronidazole compared with two standard multidrug regimens for the treatment of acute pelvic inflammatory disease. J Int Med Res 2003; 31 (1): 45–54.
45. Malhotra M, Sharma JB, Batra S et al. Ciprofloxacin-tinidazole combination, fluconazole-azithromicin-secnidazole-kit and doxycycline-metronidazole combination therapy in syndromic management of pelvic inflammatory disease: a prospective randomized controlled trial. Indian J Med Sci 2003; 57 (12): 549–55.
46. Brookoff D. Compliance with doxycycline therapy for outpatient treatment of pelvic inflammatory disease. South Med J 1994; 87 (11): 1088–91.
47. Haggerty CL, F Totten PA, Astete SG et al. Failure of cefoxitin and doxycycline to eradicate endometrial Mycoplasma genitalium and the consequence for clinical cure of pelvic inflammatory disease. Sex Transm Infect 2008; 84 (5): 338–42.
48. WA Health. Guidelines for Managing Sexually Transmitted Infections http://silverbook.health.wa.gov.au/Default.asp?PublicationID=1&ParentSectionID=P1&Se...
49. Rustomjee R, Kharsany AB, Connolly CA, Karim SS. A randomized controlled trial of azithromycin versus doxycycline/ciprofloxacin for the syndromic management of sexually transmitted infections in a resource-poor setting. J Antimicrob Chemother 2002; 49 (5): 875–8.
Авторы
Е.А.Ушкалова
ФГУ Научный центр акушерства, гинекологии и перинатологии им. В.И.Кулакова Минздравсоцразвития РФ
________________________________________________
E.A.Ushkalova
V.I.Kulakov State Research Centre of obstetrics, gynecology and perinatology of the Ministry of Health and social development of the Russian Federation, Moscow