|
|
Patient Management/Treatment
Antimicrobial
resistance
is an increasing problem in the U.S. Resistance to one or
more different antimicrobials can be found in more than
20%-30% of gonococci. Quinolone-resistant N. gonorrhoeae
(QRNG) has been reported throughout the globe and is
relatively common in parts of Asia and the Pacific.
Quinolones are no longer recommended therapy for gonorrhea
treatment.
In addition, approximately 20% of gonorrhea isolates are
resistant to penicillin, tetracycline, or both and the
emergence of multi-drug resistant isolates (resistant to
penicillin, tetracycline, and fluorquinolone) with decreased
susceptibility to cefixime has been noted. Approximately 3%
of gonorrhea isolates show decreased susceptibility to
azithromycin. Decreased susceptibility to ceftrixone,
cefixime and spectinomycin is unusual but has been reported.
(Click on image for larger view)
|
Treatment Recommendations
The 2006 CDC recommendations for the treatment of gonorrhea are as follows:
|
Uncomplicated Infections of the Cervix, Urethra, and Rectum
|
Recommended Regimens
Ceftriaxone 125 mg IM in a single dose,
OR
Cefixime 400 mg orally in a single dose
|
|
Patients infected with N. gonorrhoeae often are coinfected with C. trachomatis. This finding led to the recommendation that patients treated for gonococcal infection should also be treated routinely with a regimen effective against uncomplicated genital C. trachomatis infection. Routine dual therapy without testing for chlamydia can be cost effective.
Unless chlamydial infection is ruled out, CDC recommends the following for
co-treatment for C. trachomatis:
Azithromycin 1 g orally in a single dose
OR
Doxycycline 100 mg orally twice a day for 7 days
|
|
|
|
