Mecillinam for Treatment of Genital Chlamydia Infection

Overview

The mainstay of treating both symptomatic and asymptomatic genital Chlamydia trachomatis infection has been macrolide antibiotics in the form of azithromycin, and alternatively tetracycline antibiotics in the form of doxycycline. Studies from the late nineties found a single dose of 1 g azithromycin to be equally effective as a 7 day course of 200 mg doxycycline a day. However, recent studies have reported increasing treatment failure that may indicate that resistance to macrolide antibiotics among Chlamydia trachomatis is evolving. Research regarding other bacterial species indicates a high frequency of mutation based resistance in conjunction with azithromycin use, i.e. when treating Mycoplasma genitalium infections. There has only been case reports of tetracycline resistance among human Chlamydia isolates, but a recent study suggest that there might be decreasing effectiveness also for doxycycline. Veterinaries has for several years observed increasing prevalence of tetracycline resistance among Chlamydia suis. Within the Chlamydia population there is promiscuous horizontal gene transfer.

If the current trend of declining cure rates continues, the investigators might face a situation where there are no documented and effective treatments for Chlamydia trachomatis infections. This underline an urgent need to expand the number of documented treatment options and mecillinam seems to be one of the options that warrant further investigation.

The objectives of this study is to prove the concept of treating genital Chlamydia trachomatis with mecillinam (Pivmecillinamhydrochlorid).

Full Title of Study: “Mecillinam for Treatment of Genital Chlamydia Infection in Asymptomatic Men”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: April 2015

Interventions

  • Drug: Pivmecillinamhydrochlorid
    • PO 400 mg x3 for 7 days

Arms, Groups and Cohorts

  • Experimental: Pivmecillinamhydrochlorid
    • Selexid 400 mg x 3 , 7 days

Clinical Trial Outcome Measures

Primary Measures

  • Negative control test for Chlamydia in urine (NAAT; Nucleic Acid AmplificationTest)
    • Time Frame: 3 weeks after end of treatment

Participating in This Clinical Trial

Inclusion Criteria

  • Proficient in oral and written Norwegian
  • Positive NAAT in first void urine for Chlamydia trachomatis
  • Negative NAAT in first void urine for Mycoplasma genitalium
  • Heterosexual male
  • Asymptomatic

Exclusion Criteria

  • Known allergies for mecillinam, penicillin or cephalosporines
  • Metabolic anomalies of aciduric type
  • Apparent underweight
  • Use of mecillinam within the last two months
  • Under treatment with Valproat, other anti-infective drugs, immuno-modulating medication
  • In the opinion of investigator,obvious reasons why patient will fails to adhere to treatment and follow-up protocol

Gender Eligibility: Male

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Oslo University Hospital
  • Collaborator
    • Møre og Romsdal Hospital Trust
  • Provider of Information About this Clinical Study
    • Principal Investigator: Anne Olaug Olsen, MD PhD – Oslo University Hospital
  • Overall Official(s)
    • Anne Olaug Olsen, MD, PhD, Principal Investigator, Oslo UniversityHospital , Olafia Clinic

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