Academic Journal
Chlamydia prescribing trends in Australia before and after a national guideline update: a retrospective study of sentinel surveillance data, 2015-2025.
| Τίτλος: | Chlamydia prescribing trends in Australia before and after a national guideline update: a retrospective study of sentinel surveillance data, 2015-2025. |
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| Συγγραφείς: | Munari SC; Burnet Institute, Melbourne, Vic, Australia.; Melbourne School of Public Health, The University of Melbourne, Melbourne, Vic, Australia., Goller JL; Melbourne School of Public Health, The University of Melbourne, Melbourne, Vic, Australia., Wilkinson AL; Burnet Institute, Melbourne, Vic, Australia.; Melbourne School of Public Health, The University of Melbourne, Melbourne, Vic, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia., Coombe J; Melbourne School of Public Health, The University of Melbourne, Melbourne, Vic, Australia., Polkinghorne VAL; Burnet Institute, Melbourne, Vic, Australia., Traeger MW; Burnet Institute, Melbourne, Vic, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia., Asselin J; Burnet Institute, Melbourne, Vic, Australia., Chow EPF; Melbourne School of Public Health, The University of Melbourne, Melbourne, Vic, Australia.; Melbourne Sexual Health Centre, Bayside Health, Melbourne, Vic, Australia.; School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia., Varma R; Sydney Sexual Health Centre, Sydney, NSW, Australia.; Kirby Institute, University of New South Wales, Sydney, Australia., Bell C; Communicable Disease Control Branch, Department of Health South Australia, Adelaide, SA, Australia.; Adelaide Sexual Health Centre and Royal Adelaide Hospital, Adelaide, SA, Australia., Hocking JS; Melbourne School of Public Health, The University of Melbourne, Melbourne, Vic, Australia., Hellard M; Burnet Institute, Melbourne, Vic, Australia.; Department of Infectious Diseases, Alfred Hospital, Melbourne, Vic, Australia.; Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Vic, Australia.; Doherty Institute and Melbourne School of Public Health, The University of Melbourne, Vic, Australia. |
| Πηγή: | Sexual health [Sex Health] 2026 Oct 20; Vol. 23 (5). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: CSIRO Pub Country of Publication: Australia NLM ID: 101242667 Publication Model: Print Cited Medium: Internet ISSN: 1449-8987 (Electronic) Linking ISSN: 14485028 NLM ISO Abbreviation: Sex Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Collingwood, Vic. Australia : CSIRO Pub., c2004- |
| Ιατρικοί όροι (MeSH): | Chlamydia Infections*/drug therapy , Anti-Bacterial Agents*/therapeutic use , Doxycycline*/therapeutic use , Practice Patterns, Physicians'*/statistics & numerical data , Practice Patterns, Physicians'*/trends, Australia/epidemiology ; Azithromycin/therapeutic use ; Humans ; Male ; Sentinel Surveillance ; Female ; Retrospective Studies ; Adult ; Middle Aged ; Adolescent ; Aged, 80 and over ; Practice Guidelines as Topic ; Aged ; Young Adult |
| Περίληψη: | Background: This study investigated prescribing practices following changes in the Australian chlamydia treatment guidelines in 2022, which replaced doxycycline or azithromycin with doxycycline as first-line therapy for oropharyngeal or urogenital infections. Methods: Data from 61 clinics in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of STIs and blood-borne viruses (ACCESS) project (January 2015-June 2025) from individuals aged 16-80 years with positive urogenital or pharyngeal chlamydia tests were analysed. An interrupted time series analysis (intervention point Q1 2022) assessed quarterly changes in the proportion of tests prescribed doxycycline and azithromycin within 14 days before and 31 days after positive tests. Anorectal infections were excluded as doxycycline was already the first line recommendation for this anatomical site. Results: A total of 69,925 positive tests (53,202 (76.1%) at sexual health clinics (SHCs)) from 60,084 people were included. Doxycycline prescribing increased by 1.61 percentage points (95% CI, 1.47-1.75) per quarter before the guideline change; immediately increased by 13.5 percentage points (95% CI, 8.58-18.4); then increased by 1.70 percentage points (95% CI, 1.08-2.31) post-change. The proportion treated with azithromycin decreased by 0.62 percentage points (95% CI, -0.79 to -0.44) per quarter pre-guideline change; immediately decreased at the change by 18.1 percentage points (95% CI, -22.75 to -13.52); then decreased 1.64 percentage points (95% CI, -2.09 to -1.19) post-change. SHCs and general practices specialising in the care of gay and bisexual men showed greater pre-change increases in doxycycline prescribing, whereas general practice and community health accelerated post-change. Conclusions: Doxycycline prescribing for chlamydia has increased with corresponding declines in azithromycin use following the 2022 Australian treatment guideline change. Setting-specific implementation strategies may accelerate evidence uptake for future guideline updates. (© 2026 The Author(s) (or their employer(s)). Published by CSIRO Publishing.) |
| Contributed Indexing: | Keywords: azithromycin; chlamydia; doxycycline; guidelines; public health; sentinel surveillance; sexually transmissible infections; treatment |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents) N12000U13O (Doxycycline) 83905-01-5 (Azithromycin) |
| Entry Date(s): | Date Created: 20260930 Date Completed: 20260930 Latest Revision: 20260930 |
| Update Code: | 20261001 |
| DOI: | 10.1071/SH26148 |
| PMID: | 42815879 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1449-8987 |
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| DOI: | 10.1071/SH26148 |