Download CHLORTETRACYCLINE

CHLORTETRACYCLINE
 CLINICAL APPLICATIONS
 THERAPEUTIC USES
 C. CHLAMYDIAL INFECTIONS
 1. OVERVIEW:
FDA APPROVAL: Adult, no; pediatric, no
EFFICACY: Adult, possibly effective;
pediatric,
possibly effective
DOCUMENTATION: Adult, fair; pediatric, fair
 2. SUMMARY:
- Chlortetracycline alone or in combination
therapy
has been effective in treatment of
chlamydial
infections
- Neonatal ocular chlamydial infection best
treated
with chlortetracycline/erythromycin
combination
- Controlled studies are lacking
 3. ADULT:
 a. In an open study of 69 men with chlamydia-positive nonspecific or
post-gonococcal urethritis, chlortetracycline 250 milligrams four times
a day oral dose was administered for either 4 to 10 days or 12 to 18
days. The total number of resolved cases was 71%, with a better
score for the long-term treatment (80%) than the short-term (59%)
group. In four cases in the short-term group (14%), the relapse with
re-isolation of C trachomatis was observed but without significant
difference. The minimum inhibitory concentration (MIC) has ranged
from 0.02 to 1 microgram per milliliter (Terho, 1978).
 b. In an open study, 75 chlamydia-positive women were treated with
triple tetracycline combination: chlortetracycline hydrochloride 115.4
milligrams (mg) plus tetracycline hydrochloride 115.4 mg plus
demeclocycline hydrochloride 69.2 mg (Deteclo(R) 300 mg) twice
daily for 7 or 21 days. Chlamydia was eradicated from the female
genital tract during both treatment periods (Waugh & Nayyar, 1977).
 c. For More Information:
 See Drug Consult reference: "CHLAMYDIAL INFECTIONS 1998 CDC GUIDELINES"
 See Drug Consult reference: "CHLAMYDIA-INDUCED
URETHRITIS, CERVICITIS, CONJUNCTIVITIS, PROCTITIS DRUG OF CHOICE"
 See Drug Consult reference: "CHLAMYDIA TRACHOMATIS DRUG OF CHOICE"
 4. PEDIATRIC:
 a. Neonatal ocular chlamydial infection can be adequately treated
with chlortetracycline 1% eye ointment in association with systemic
erythromycin (30 milligrams/kilogram/day) for 21 days. Since
chlamydial ophthalmic neonatal infection is acquired during birth,
both the mother and the father should be investigated and treated
(Ridgway & Oriel, 1977).
 b. In a small study, chlortetracycline 1% eye ointment monotherapy
was effective in only 3 of 6 infants; the infection in non-responders
resolved with the addition of systemic erythromycin (40 milligrams
(mg) per kilogram per day) for 2 weeks. No failures were observed in
4 adult patients treated with chlortetracycline 1% eye ointment plus
erythromycin 500 mg twice daily for 2 weeks (Molgaard et al, 1983).
 c. For More Information:
 See Drug Consult reference: "CHLAMYDIA-INDUCED
URETHRITIS, CERVICITIS, CONJUNCTIVITIS, PROCTITIS DRUG OF CHOICE