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Azithromycin persists for a week in vagina

15 May 2017

Azithromycin is present at high levels in the vagina for up to a week after administration of a 1-gram dose, a new study shows. Poor absorption of the antibiotic is thus not the cause of treatment failure.

The study involved self-collected vaginal swabs from 21 women; 11 (median age 30 [24 to 38] years)of which repeatedly collected samples within 24 hours after azithromycin treatment, while 10 (median age 34 [20 to 48] years) swabbed repeatedly over 9 days post-treatment. Only those without Chlamydia were included while those with contraindications to azithromycin and who were pregnant were excluded.

Blood samples were also collected from the participants. Liquid chromatography-mass spectrometry was used to measure azithromycin levels from the sample. Phosphatidylcholine and leucine enkephalin were used as internal standards.

Each of the 11 women provided 12 vaginal swabs over the course of a 24-hour period, while each of the 10 women provided 10 swabs over the course of a 9-day period.

Of the 24-hour swabs, concentrations of the leu-enkephalin internal controls remained consistent across all runs and samples, suggesting consistency in sample preparation. The mean normalized concentration of azithromycin an hour after treatment was 136 (1 to 1,453) mcg/mg of lipid.

The highest mean dose was observed 5 hours post-treatment and was calculated to be 1,031 (173 to 2,693) mcg/mg. The increase was statistically significant (p<0.001). Mean plasma azithromycin concentration was 915 (388 to 1,406) ng/mL 4 hours after treatment.

The mean normalized azithromycin was highest at 2 days after treatment (2,206 [721 to 5,791] mcg/mg of lipid) in the 9-day swab samples. The lowest mean concentration was 384 (139 to 1,024) mcg/mg reported 9 days after treatment. The decline was statistically significant (p=0.01).Finally, mean plasma concentration of azithromycin after 4 hours was 930 (408 to 1,518) ng/mL.

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Most Read Articles
Elvira Manzano, 5 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, Yesterday
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.