Accueil
Recherche
Nouveautés
Email webmaster
Sommaire général
Page précédente
WHO GUIDELINES FOR THE
Treatment of Chlamydia trachomatis

[Texte complet / OMS]
2016

Face à la résistance aux antibiotiques des maladies sexuellement transmissibles (MST), des traitements adaptés sont nécessaires, notamment pour trois infections que sont la chlamydiose, la gonorrhée et la syphilis. Telles sont les recommandations formulées mardi par l’Organisation mondiale de la santé, pour qui l’antibiorésistance est un « problème de plus en plus préoccupant ». Et ce, alors même que chaque année, 131 millions de personnes contractent la chlamydiose, 78 millions la gonorrhée et 5,6 millions la syphilis.

Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting quality of life and causing serious morbidity and mortality. STIs have a direct impact on reproductive and child health through infertility, cancers and pregnancy complications, and they have an indirect impact through their role in facilitating sexual transmission of human immunodeficiency virus (HIV) and thus they also have an impact on national and individual economies.
More than a million STIs are acquired every day. In 2012, an estimated 357 million new cases of curable STIs (gonorrhoea, chlamydia, syphilis and trichomoniasis) occurred among 15–49 year-olds worldwide, including 131 million cases of chlamydial infection.

Voir également : IST - MST : recommandation 2016 de la SFD [Lire]

The following recommendations apply to adults, adolescents (10-19 years of age), people living with HIV, and key populations, including sex workers, men who have sex with men (MSM) and transgender persons. Specific recommendations have also been developed for ophthalmia neonatorum caused by C. trachomatis.

RECOMMENDATION 1: UNCOMPLICATED GENITAL CHLAMYDIA
For people with uncomplicated genital chlamydia, the WHO STI guideline suggests one of the following options: • azithromycin 1 g orally as a single oral dose • doxycycline 100 mg orally twice a day for 7 days or one of these alternatives: • tetracycline 500 mg orally four times a day for 7 days • erythromycin 500 mg orally twice a day for 7 days • ofloxacin 200-400 mg orally twice a day for 7 days. Conditional recommendation, moderate quality evidence

RECOMMENDATION 2 : ANORECTAL CHLAMYDIAL INFECTION In people with anorectal chlamydial infection, the WHO STI guideline suggests using doxycycline 100 mg orally twice daily for 7 days over azithromycin 1 g orally single dose. Conditional recommendation, low quality evidence

RECOMMENDATION 3 : CHLAMYDIAL INFECTION IN PREGNANT WOMEN
Dosages:
• azithromycin 1 g orally as a single dose
• amoxicillin 500 mg orally three times a day for 7 days
• erythromycin 500 mg orally twice a day for 7 days.
Remarks: Azithromycin is the first choice of treatment but may not be available in some settings. Azithromycin is less expensive than erythromycin and since it is provided as a single dose, may result in better adherence and therefore better outcomes.
RECOMMENDATION 3A In pregnant women with genital chlamydial infection, the WHO STI guideline recommends using azithromycin over erythromycin.
Strong recommendation, moderate quality evidence
RECOMMENDATION 3B In pregnant women with genital chlamydial infection, the WHO STI guideline suggests using azithromycin over amoxicillin. Conditional recommendation, low quality evidence
RECOMMENDATION 3C In pregnant women with genital chlamydial infection, the WHO STI guideline suggests using amoxicillin over erythromycin. Conditional recommendation, low quality evidence

RECOMMENDATION 4 : LYMPHOGRANULOMA VENEREUM (LGV)
In adults and adolescents with LGV, the WHO STI guideline suggests using doxycycline 100 mg orally twice daily for 21 days over azithromycin 1 g orally, weekly for 3 weeks. Conditional recommendation, very low quality evidence

RECOMMENDATION 5 : OPHTHALMIA NEONATORUM
In neonates with chlamydial conjunctivitis, the WHO STI guideline recommends using oral azithromycin 20 mg/kg/day orally, one dose daily for 3 days, over erythromycin 50 mg/kg/day orally, in four divided doses daily for 14 days.
Strong recommendation, very low quality evidence

RECOMMENDATION 6 : Ophthalmia neonatorum prophylaxis
For all neonates, the WHO STI guideline recommends topical ocular prophylaxis for the prevention of gonococcal and chlamydial ophthalmia neonatorum. Strong recommendation, low quality evidence

RECOMMENDATION 7 : Ophthalmia neonatorum prophylaxis
For ocular prophylaxis, the WHO STI guideline suggests one of the following options for topical application to both eyes immediately after birth:
• tetracycline hydrochloride 1% eye ointment
• erythromycin 0.5% eye ointment
• povidone iodine 2.5% solution (water-based)
• silver nitrate 1% solution
• chloramphenicol 1% eye ointment.
Conditional recommendation, low quality evidence



.
Accueil
Recherche
Nouveautés
Email webmaster
Sommaire général
Page précédente