Cefaclor, an alternative to third generation cephalosporins for the treatment of gonococcal urethritis in the developing world?

Crabbé, F; Grobbelaar, T M; Dyck, E Van; Dangor, Y; Laga, Marie; Ballard, Ronald C.

doi:10.1136/sti.73.6.506

Cited by 2 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Oral cephalosporins with activity against N. gonorrhoeae include cefuroxime axetil,69, 70 cefaclor,71 cefixime,72-75 cefpodoxime proxetil,76, 77 ceftibuten,78 cefdinir,79 and cefoperozone (see Table 1). 80, 81 The WHO recommends cefixime 400mg and in the United States, cefixime 400mg is the only oral regimen recommended as first line therapy.…”

Section: Cephalosporins For the Treatment Of Gonococcal Infectionsmentioning

confidence: 99%

The use of cephalosporins for gonorrhea: the impending problem of resistance

Barry

Klausner²

2009

Expert Opinion on Pharmacotherapy

149

118

View full text Add to dashboard Cite

Gonorrhea remains an important clinical and public health problem throughout the world. Gonococcal infections have historically been diagnosed by Gram stain and culture, but are increasingly diagnosed through nucleic acid tests thereby eliminating the opportunity for antimicrobial susceptibility testing. Gonococcal infections are typically treated with single-dose therapy with an agent found to cure >95% of cases. Unfortunately, the gonococcus has repeatedly developed resistance to antimicrobials including sulfonamides, penicillin, tetracyclines, and fluoroquinolones. This has left third-generation cephalosporins as the lone class of antimicrobials currently recommended as first line therapy for gonorrhea in some regions. However, resistance to oral third-generation cephalosporins has emerged and spread in Asia, Australia and elsewhere. The mechanism of this resistance seems to be associated with a mosaic penicillin binding protein (penA) in addition to other chromosomal mutations previously found to confer resistance to beta-lactam antimicrobials (ponA, mtrR, penB, pilQ). Few good options exist or are in development for treating cephalosporin resistant isolates as most have had multidrug resistance. Preventing the spread of resistant isolates will depend on ambitious antimicrobial management programs, strengthening and expanding surveillance networks, and through effective sexually transmitted disease control and prevention.

show abstract

Section: Cephalosporins For the Treatment Of Gonococcal Infectionsmentioning

confidence: 99%

The use of cephalosporins for gonorrhea: the impending problem of resistance

Barry

Klausner²

2009

Expert Opinion on Pharmacotherapy

149

118

View full text Add to dashboard Cite

show abstract

Antimicrobial Resistance ofNeisseria gonorrhoeaeIsolated in Korea

Lee

Chong

2012

J Bacteriol Virol

View full text Add to dashboard Cite

Neisseria gonorrhoeae is the causative agent of gonorrhea, one of the most important sexually transmitted diseases. The incidence of gonorrhea is still prevalent and about 50,000 new cases have been reported annually during the late 2000s in Korea. The antimicrobial resistance of N. gonorrhoeae is very prevalent and most isolates are multi-drug resistant to penicillin G, tetracycline, and fluoroquinolones. The incidence of penicillinase-producing N. gonorrhoeae (PPNG) decreased significantly, but high-level tetracycline-resistant N. gonorrhoeae (TRNG) increased recently. The minimum inhibitory concentrations (MICs) of ceftriaxone were within the susceptible range for all isolates, but MIC creep has been apparent and one cefixime-nonsusceptible isolate (0.5 μg/ml) was found. Spectinomycin-resistant isolates remain rare, but caution should be required when dealing with gonococcal pharyngitis.

show abstract

Cefaclor, an alternative to third generation cephalosporins for the treatment of gonococcal urethritis in the developing world?

Cited by 2 publications

References 12 publications

The use of cephalosporins for gonorrhea: the impending problem of resistance

The use of cephalosporins for gonorrhea: the impending problem of resistance

Antimicrobial Resistance ofNeisseria gonorrhoeaeIsolated in Korea

Contact Info

Product

Resources

About