Rifalazil for the treatment of non-gonococcal urethritis and chlamydia infections

Rifalazil (benzoxacinorifamycin), a recently developed antibacterial drug, is the first representative of a new generation of long-acting ansamycins. Rifalazil has high bactericidal activity against a wide range of pathogens (including Helicobacter pylori, Clostridium difficile, chlamydia, mycobacteria, methicillin resistant strains Staphylococcus aureus and other grams -Multi-resistant bacteria), long half-life (more than 100 hours), as well as a strong penetration into the cells (more than 300: 1). All of the above suggests that rifalazil is more effective than standard regimens for a number of diseases, including non-gonococcal urethritis (NSU).

To confirm this hypothesis, a randomized double-blind study was conducted comparing the clinical and microbiological efficacy of a single dose of rifalazil (at a dose of 2, 5, 12.5 and 25 mg) and azithromycin (1 g) in the treatment of NSU and chlamydia infections. The study involved 111 men aged 18 to 45 with NSU. The effectiveness of the therapy was evaluated after 2 and 5 weeks.

The clinical efficacy of treatment with rifalazil at a dose of 25 mg was observed in 86% of patients after 2 weeks and 59% after 5 weeks, microbiological efficacy was observed in 85% and 83% of patients respectively. In the group of patients receiving azithromycin, clinical efficacy reached 77% after 2 weeks and 63% after 5 weeks, microbiological - 83% and 64%, respectively. Given the clinical and microbiological efficacy, the overall efficacy of rifalazil treatment was 85% compared to 58% for azithromycin.

Adverse events were observed in 23% of patients treated with rifalazil and 24% of patients treated with azithromycin. All adverse events were mild or moderate and were mainly represented by headache (14%) during treatment with rifalazil and symptoms of the gastrointestinal tract (12%) during treatment with keftab.

Thus, rifalazil is an effective and relatively safe alternative to treatment with azithromycin. As a number of studies have shown, it can also be used to treat other illnesses, such as infectious colitis.