Effects of azithromycin and doxycycline on the vaginal microbiota of women with urogenital Chlamydia trachomatis infection: a substudy of the Chlazidoxy randomized controlled trial.
Details
Serval ID
serval:BIB_8E4172B83661
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effects of azithromycin and doxycycline on the vaginal microbiota of women with urogenital Chlamydia trachomatis infection: a substudy of the Chlazidoxy randomized controlled trial.
Journal
Clinical microbiology and infection
Working group(s)
Chlazidoxy study group
Contributor(s)
Baita D., Ouziel-Duretz C., Poudens B., Brun R., Jouvert S., Tesson A., Carrière J., Diaz M., Forget C., Le Hen I., Ahano-Ducourneau F., Van D.H., Robert P., Brun F., Lhospital E., Bardou J., Guegan A., Moura S.R., Leriche C., De Cussy A., Malfait M., Rychen C., Martinet P., Kugeler A., Barriere L., Gutierrez L., Robert J.L., Saule J., Bergamaschi V., Soltana S.B., Aymar-Moulene D., Bernier C., Lecompte A.S., Gregoire A., Girard T., Naccache M.A., Lefebvre P., Crombe P., Bulot C., Rolland A.L., Dernivoix K., Trouillet C., Trignol-Viguier N., Blin-Zbiegiel E., Boissinot M., Joly B., Dubreuil A., Mathieu C., Pragout D., Bébéar C., Grob A., Zaffreya S., Le Naour E., Gibaud A.S., Lanotte P., Vachée A., Loubinoux J., Touati A., Balcon C., Roussillon C., Ghezzoul B., Perry F., Turuban C., Rapin S., Pastor C., Cavellec M., Manvri E.P., Albane S., Dernivoix K., Trouillet C., Ghiringhelli E., Pantin K., Kret M., Lhomme E., Garreau D., Galet J.
ISSN
1469-0691 (Electronic)
ISSN-L
1198-743X
Publication state
Published
Issued date
08/2023
Peer-reviewed
Oui
Volume
29
Number
8
Pages
1056-1062
Language
english
Notes
Publication types: Randomized Controlled Trial ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Dysbiotic bacterial communities within the vagina are associated with Chlamydia trachomatis infection. We compared the effect of treatment with azithromycin and doxycycline on the vaginal microbiota in a cohort of women with a urogenital C. trachomatis infection randomly assigned to one of these treatments (Chlazidoxy trial).
We analysed vaginal samples from 284 women (135 in the azithromycin group and 149 in the doxycycline group) collected at baseline and 6 weeks after treatment initiation. The vaginal microbiota was characterized using 16S rRNA gene sequencing and classified into community state types (CSTs).
At baseline, 75% (212/284) of the women had a high-risk microbiota (CST-III or CST-IV). A cross-sectional comparison 6 weeks after treatment showed that 15 phylotypes were differentially abundant, but this difference was not reflected at the CST (p 0.772) or diversity level (p 0.339). Between baseline and the 6-week visit, α-diversity (p 0.140) and transition probabilities between CSTs were not significantly different between the groups, and no phylotype was differentially abundant.
In women with urogenital C. trachomatis infection, the vaginal microbiota does not seem to be affected by azithromycin or doxycycline 6 weeks after treatment. Because the vaginal microbiota remains susceptible to C. trachomatis infection (with CST-III or CST-IV) after antibiotic treatment, women remain at risk of reinfection, which could originate from unprotected sexual intercourse or untreated anorectal C. trachomatis infection. This last consideration advocates for the use of doxycycline instead of azithromycin because of its higher anorectal microbiological cure rate.
We analysed vaginal samples from 284 women (135 in the azithromycin group and 149 in the doxycycline group) collected at baseline and 6 weeks after treatment initiation. The vaginal microbiota was characterized using 16S rRNA gene sequencing and classified into community state types (CSTs).
At baseline, 75% (212/284) of the women had a high-risk microbiota (CST-III or CST-IV). A cross-sectional comparison 6 weeks after treatment showed that 15 phylotypes were differentially abundant, but this difference was not reflected at the CST (p 0.772) or diversity level (p 0.339). Between baseline and the 6-week visit, α-diversity (p 0.140) and transition probabilities between CSTs were not significantly different between the groups, and no phylotype was differentially abundant.
In women with urogenital C. trachomatis infection, the vaginal microbiota does not seem to be affected by azithromycin or doxycycline 6 weeks after treatment. Because the vaginal microbiota remains susceptible to C. trachomatis infection (with CST-III or CST-IV) after antibiotic treatment, women remain at risk of reinfection, which could originate from unprotected sexual intercourse or untreated anorectal C. trachomatis infection. This last consideration advocates for the use of doxycycline instead of azithromycin because of its higher anorectal microbiological cure rate.
Keywords
Female, Humans, Azithromycin/pharmacology, Azithromycin/therapeutic use, Doxycycline/pharmacology, Doxycycline/therapeutic use, Chlamydia trachomatis/genetics, RNA, Ribosomal, 16S/genetics, Cross-Sectional Studies, Chlamydia Infections/drug therapy, Chlamydia Infections/microbiology, Anti-Bacterial Agents/pharmacology, Anti-Bacterial Agents/therapeutic use, Vagina/microbiology, Microbiota, Urinary Tract Infections/drug therapy, 16S rRNA gene sequencing, Antibiotics, Chlamydia trachomatis treatment, Community state types, Vaginal microbiome
Pubmed
Web of science
Create date
01/05/2023 8:38
Last modification date
19/12/2023 8:12
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