Evaluation of doxycycline in the treatment of chlamydial salpingitis

Acute salpingitis caused by Chlamydia trachomatis and other associated pathogens was diagnosed in 55 patients by means of laparoscopy and serological tests. All patients were treated with intravenous injections of doxycycline (200 mg/day) for four days followed by the same dosage orally for 20 days. Other antibiotics were given concomitantly for the associated infections. Treatment efficacy was evaluated on day 7 and day 30. Clinical symptoms had disappeared in 45 (82%) of the patients, and improvement was seen in another four (11%). Failure to improve in six cases was attributed to concurrent infection with microorganisms other than C trachomatis. After 30 days of treatment, two infections attributed to C trachomatis had not been cured with the doxycycline treatment; one of the patients was believed to have been reinfected and the other did not follow the prescribed treatment. The finding of clinical failure due to associated infection, sometimes discovered after two or three weeks of treatment, necessitates treatment of chlamydial salpingitis with multiple antibiotics, subsequent follow-up procedures (laparoscopic and serological), and appropriate changes in antibiotic therapy after C trachomatis has been eradicated but other pathogens remain.