Authors
Chebotarev V. V.
Doctor of Medicine, Professor, Head, Department of Dermathovenerology1
Aschakov M. S.
PhD, Assistant, Department of Dermathovenerology1
Chebotareva N. V.
Doctor of Medicine, Professor, Department of Dermathovenerology2
Shchetinin E. V.
Doctor of Medicine, Professor, Head, Department of Pathophysiology1
1 - Stavropol State Medical University
2 - RUDN University, Moscow
Corresponding author
Evgeny V. Shchetinin; e-mail: ev.cliph@rambler.ru
Conflict of interest
None declared.
Abstract
Introduction. In various clinical recommendations, jozamycin and azithromycin are indicated along with doxycycline as the drugs of choice in urogenital chlamydia. However, given the experience of clinical trials, meeting the requirements of evidence-based medicine, such recommendations raise a number of questions that require at least clarifications. Aim of the study. Evaluate the evidence base for the effectiveness of the use of various macrolide antibiotics in the treatment of urogenital infections. Material and methods. A profound temporal analysis of the clinical results of use, pharmacokinetic, pharmacological properties, the mechanism of resistance of macrolides, administered in the treatment of urogenital infection, was performed. Results of the study and their discussion. The weak points of josamycin compared with azithromycin are marked: the shortest half-life, the absence of two peak concentrations in the blood, less pronounced anti-inflammatory effect, the lack of sub-MPK effect and compliance. It is pointed out that the inclusion of josamycin into federal clinical guidelines for the treatment of various forms of urogenital pathology, including pregnant women, is a wrong choice, since the evidence base for the effectiveness and safety of azithromycin is much broader. Conclusion. The results suggest a greater commercial interest in the promotion of josamycin in the pharmaceutical market, as there are no convincing clinical evidence and pharmacokinetic justifications for its large-scale application.
Key words
macrolides, azithromycin, josamycin, pharmacokinetics, treatment
DOI
References
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