The American College of Obstetrics and Gynecology recommends two-part treatment for gonococcal infection
Gonorrhea is the second most common sexually transmitted bacterial infection in the United States. In the United States, approximately 820,000 new cases of Neisseria gonorrhoeae are registered each year. The stability of the pathogen limits the success of treatment, increases the risk of complications and can contribute to the spread of the disease in the population. Neisseria gonorrhoeae is currently resistant to penicillins, tetracyclines and sulfonamides. Since 2007, due to the proliferation and increased resistance of gonococci to fluoroquinolones, the United States Centers for Disease Control and Prevention (CDC) has no longer recommended the use of fluoroquinolones in gonorrhea. The only remaining class of antimicrobial agents with a high level of activity against Neisseria gonorrhoeae are cephalosporins.
According to the recommendations of the American College of Obstetricians and Gynecologists (ACOG), published in the November issue of Obstetrics & Gynecology, a two-component therapy for gonococcal infection is currently recommended in the United States. United.
The first line of treatment for the treatment of gonorrhea is a combination of ceftriaxone and azithromycin. ACOG recommends the use of ceftriaxone and azithromycin together on the same day, preferably simultaneously under the direct supervision of a doctor or nursing staff.
The recommended dose of ceftriaxone for the treatment of uncomplicated gonococcal infection of the cervix, urethra and rectum is 250 mg once a month, azithromycin - 1 g once inside. Second-line drugs are cefixime inward + azithromycin inward, and if there is anamnestic data on severe allergic reactions to beta-lactams, combinations of hemifloxacin + azithromycin or gentamicin (w / m) + azithromycin are used.
In the treatment of pregnant women, it is also recommended to prescribe a two-component treatment. In most cases, a healing assessment is not recommended if patients with uncomplicated gonococcal infection receive one of the treatment options with first or second row drugs. Repeated cases of gonococcal infection are more common in patients who have been diagnosed with gonorrhea and have been treated for several months before the new episode. Most of these cases are re-infections and clinicians should therefore recommend that patients with gonorrhea be re-examined 3 months after treatment. Pregnant women should be re-examined during the third trimester of pregnancy, except in situations where the patient has recently received treatment.
If a gonococcal pharyngitis is diagnosed in a woman and she has received one of the alternative treatment options, the cure should be evaluated 14 days after the end of treatment using the culture method or PCR diagnosis.
It is recommended that the sexual partners of a patient diagnosed with a gonococcal infection, with whom sexual intercourse had been before the diagnosis for 60 days, undergo an examination and a preventive treatment for infections caused by N. gonorrhoeae and Chlamydia trachomatis. Patients and their sexual partners are advised to abstain from sexual intercourse for 7 days after treatment and until the sexual partners are properly treated.