{"doi":"10.1093/cid/ciab153","title":"Doxycycline Versus Azithromycin for the Treatment of Rectal Chlamydia in Men Who Have Sex With Men: A Randomized Controlled Trial","abstract":"BACKGROUND: Azithromycin and doxycycline are both recommended treatments for rectal Chlamydia trachomatis (CT) infection, but observational studies suggest that doxycycline may be more effective. METHODS: This randomized, double-blind, placebo-controlled trial compared azithromycin (single 1-g dose) versus doxycycline (100 mg twice daily for 7 days) for the treatment of rectal CT in men who have sex with men (MSM) in Seattle and Boston. Participants were enrolled after a diagnosis of rectal CT in clinical care and underwent repeated collection of rectal swabs for nucleic acid amplification testing (NAAT) at study enrollment and 2 weeks and 4 weeks postenrollment. The primary outcome was microbiologic cure (CT-negative NAAT) at 4 weeks. The complete case (CC) population included participants with a CT-positive NAAT at enrollment and a follow-up NAAT result; the intention-to-treat (ITT) population included all randomized participants. RESULTS: Among 177 participants enrolled, 135 (76%) met CC population criteria for the 4-week follow-up visit. Thirty-three participants (19%) were excluded because the CT NAAT repeated at enrollment was negative. Microbiologic cure was higher with doxycycline than azithromycin in both the CC population (100% [70 of 70] vs 74% [48 of 65]; absolute difference, 26%; 95% confidence interval [CI], 16-36%; P < .001) and the ITT population (91% [80 of 88] vs 71% [63 of 89]; absolute difference, 20%; 95% CI, 9-31%; P < .001). CONCLUSIONS: A 1-week course of doxycycline was significantly more effective than a single dose of azithromycin for the treatment of rectal CT in MSM. CLINICAL TRIALS REGISTRATION: NCT03608774.","journal":"Clinical Infectious Diseases","year":2021,"id":152012,"datarank":3.216982887185069,"base_score":4.3694478524670215,"endowment":4.3694478524670215,"self_citation_contribution":0.6554171778700533,"citation_network_contribution":2.561565709315016,"self_endowment_contribution":0.6554171778700533,"citer_contribution":2.561565709315016,"corpus_percentile":null,"corpus_rank":null,"citation_count":78,"citer_count":71,"citers_with_citation_signal":49,"citers_with_endowment":49,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.956,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03608774"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":327415,"name":"Michael R. Wierzbicki","orcid":null,"position":1,"is_corresponding":false},{"id":301170,"name":"Lori M. Newman","orcid":"0000-0001-5464-5208","position":2,"is_corresponding":false},{"id":280636,"name":"Jonathan Powell","orcid":"0000-0002-8306-5162","position":3,"is_corresponding":false},{"id":645991,"name":"Ashley Miller","orcid":"0000-0002-9754-9731","position":4,"is_corresponding":false},{"id":647100,"name":"Dwyn Dithmer","orcid":null,"position":5,"is_corresponding":false},{"id":316703,"name":"Olusegun O. Soge","orcid":"0000-0002-8504-2319","position":6,"is_corresponding":false},{"id":305156,"name":"Kenneth H. Mayer","orcid":"0000-0001-7460-733X","position":7,"is_corresponding":false},{"id":311287,"name":"Julia C. Dombrowski","orcid":"0000-0003-1907-9428","position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":null,"created_at":"2026-07-18T23:43:22.562252Z","pmid":"33606009","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}