Antibiotic Use before Chlamydia and Gonorrhea Genital and Extragenital Screening in the Sexually Transmitted Infection Clinical Setting

Abstract

bBackground antibiotic use (i.e., administration of antibiotics not directly related to Chlamydia trachomatis or Neisseria gonorrhoeae infections) has been associated with a lower prevalence of genital C. trachomatis infection in a clinical setting. Associations with specific antibiotic types or with N. gonorrhoeae are lacking. Here, we assessed the prevalence of antibiotic use, the different classes and agents used, and their association with a subsequent sexually transmitted infection (STI) clinic C. trachomatis and N. gonorrhoeae test result. At our STI clinic, we systematically registered whether antibiotics were used in the past month (in 29% of the cases, the specific antibiotic agent was named). Patients were screened for urogenital C. trachomatis and N. gonorrhoeae; a third of them were also screened for anorectal and oropharyngeal C. trachomatis and N. gonorrhoeae. The proportion of antibiotics used and their association with C. trachomatis and N. gonorrhoeae prevalence were assessed for heterosexual men, men who have sex with men (MSM), and women. During 14,775 clinic consultations, antibiotic use was reported by 12.2% (95% confidence interval [CI], 11.7% to 12.7%), i.e., 14.8% of women, 8.6% of heterosexual men, and 11.6% of MSM. The most reported antibiotics were penicillins, tetracyclines, and macrolides, respectively. The prevalence was 11.0% (95% CI, 10.3% to 11.3%) for C. trachomatis and 1.9% (95% CI, 1.7% to 2.1%) for N. gonorrhoeae. Only tetracycline use was associated with a lower C. trachomatis prevalence (3%). Overall antibiotic use was associated with lower anorectal C. trachomatis prevalence in MSM only (odds ratio, 0.4; 95% CI, 0.2 to 0.8). STI clinic visitors commonly report recent antibiotic use. Even in a country with low antibiotic consumption, tetracycline use impacted C. trachomatis prevalence, while there was a notable absence of association with azithromycin.

Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients

“…There is consensus about the importance of early antenatal detection and effective CT treatment [9, 10]. CT-effective antibiotics prescribed for another bacterial infection can additionally treat asymptomatic CT. As such, CT can be treated “incidentally” [2], which has been shown in an Australian study and a study from our research group [11, 12]. However, the incidental beneficial effects of antibiotics on the association between CT and adverse reproductive health outcomes have not been evaluated.…”

Factors associated with anorectalChlamydia trachomatisorNeisseria gonorrhoeaetest positivity in women: a systematic review and meta-analysis

“…Overall, 25 reporting on both CT and NG anorectal positivity were eligible (Figure 1). Twelve (48%) studies were from North America [18][19][20][21][22][23][24][25][26][27][28][29], seven (28%) from the Netherlands [14,15,[30][31][32][33][34], three (12%) from the United Kingdom [35][36][37], two (8%) from South America [38,39], and one (4%) from Africa [40]. Table 1 shows that 23 studies were cross-sectional [14, 15, 18-24, 26-38, 40], one was a prospective cohort study [25] and one was a case-control [39].…”

“…Overall, 14 (56%) studies specified consecutive recruitment of patients attending clinics or inclusion of all data reducing selection bias [14, 18, 19, 22, 23, 26-31, 33, 35, 36]. Inclusion/exclusion criteria were specified for 22 (88%) studies [15,[19][20][21][22][23][24][25][26][27][28][29][30][32][33][34][35][36][37][38][39][40]. Measurement bias was considered low in 21 (84%) studies because the type of NAAT used was described.…”

Efflux in the Oral Metagenome: The Discovery of a Novel Tetracycline and Tigecycline ABC Transporter

“…Although resistance to this group of antibiotics is prevalent they are still used in the treatment of some human infections, including Chlamydia infections and some eye infections such as trachoma (Hu et al, 2010; Dukers-Muijrers et al, 2015). Tigecycline is a novel semi-synthetic derivative of tetracycline and the first of the glycylcyclines.…”