From the Research
For patients with chlamydia who have an azithromycin allergy, doxycycline is the recommended alternative treatment. The standard regimen is doxycycline 100 mg taken orally twice daily for 7 days 1. It's essential to take the full course of antibiotics even if symptoms improve before completion. During treatment, patients should abstain from sexual activity for the entire 7-day course and until their partner(s) have also been treated to prevent reinfection.
Key Considerations
- Common side effects of doxycycline include increased sun sensitivity, nausea, and diarrhea, so taking it with food (though not dairy products) can help reduce stomach upset.
- Patients should avoid sun exposure while on this medication and should not take it with antacids, iron supplements, or calcium, as these can reduce absorption.
- Doxycycline works by inhibiting bacterial protein synthesis, effectively stopping the chlamydia bacteria from reproducing.
Alternative Treatments
If doxycycline cannot be used, other alternatives like levofloxacin or erythromycin may be considered, but these would require consultation with a healthcare provider to determine the appropriate alternative based on individual factors 2, 3.
Evidence Summary
Recent studies, including a randomized controlled trial published in 2021, have shown that doxycycline is more effective than azithromycin for the treatment of rectal chlamydia in men who have sex with men 1. Another study published in 2021 also found that doxycycline was superior to azithromycin for the treatment of rectal Chlamydia trachomatis infection among men who have sex with men 3.