Update on the Management of Gonorrhea in Adults in the United States

Abstract

Gonorrhea, the second most commonly reported notifiable disease, is an important cause of cervicitis, urethritis, and pelvic inflammatory disease. The selection of appropriate therapy for gonorrhea (i.e., safe, highly effective, single dose, and affordable) is complicated by the ability of Neisseria gonorrhoeae to develop resistance to antimicrobial therapies. This article reviews the key questions and data that informed the 2006 gonorrhea treatment recommendations of the Centers for Disease Control and Prevention. Key areas addressed include the criteria used to select effective treatment for gonorrhea, the level of antimicrobial resistance at which changing treatment regimens is recommended, the epidemiology of resistance, and the use of quinolones, cephalosporins, and other classes of antimicrobials for the treatment of uncomplicated gonorrhea.

2012 European guideline on the diagnosis and treatment of gonorrhoea in adults

“…[56][57][58][59][60]71,72 This correlates with the pharmacokinetic properties of the individual antimicrobials. Treatment with spectinomycin has poor efficacy at eradicating pharyngeal gonorrhoea.…”

Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from patients attending a public referral center for sexually transmitted diseases in Belo Horizonte, State of Minas Gerais, Brazil

“…Ciprofl oxacin resistance is greatly increased (21.4%) compared to other national studies. These studies initially observed decreased susceptibility 19,21 followed by drug resistance in Manaus 23 27 (47.7%), have detected high levels of resistance to ciprofl oxacin, and thus its use for the treatment of gonorrhea has been discontinued in these locations 4,32,33 . In addition, specimens with a high level of resistance to ciprofl oxacin (MIC>32µg/ml) that also exhibited resistance to chloramphenicol and tetracycline were identifi ed.…”

Corneal Perforation in a Patient with History of Unidentified Urethritis

“…In corneal melting cases where there is no correct response to treatment and the perforation risk is imminent, or has already been produced, keratoplasty has proven to be the most efficient invasive therapy and could therefore restore the globe in its whole. It could also reduce the risk of endophthalmitis, if it used at an early stage as in our case [9] [10].…”