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Resistance-Guided Treatment of Gonorrhea: A Prospective Clinical Study.
Klausner, Jeffrey D; Bristow, Claire C; Soge, Olusegun O; Shahkolahi, Akbar; Waymer, Toni; Bolan, Robert K; Philip, Susan S; Asbel, Lenore E; Taylor, Stephanie N; Mena, Leandro A; Goldstein, Deborah A; Powell, Jonathan A; Wierzbicki, Michael R; Morris, Sheldon R.
Afiliación
  • Klausner JD; Departments of Medicine and Epidemiology, University of California, Los Angeles, Los Angeles, California, USA.
  • Bristow CC; Department of Medicine, University of California, San Diego, La Jolla, California, USA.
  • Soge OO; Neisseria Reference Laboratory, University of Washington, Seattle, Washington, USA.
  • Shahkolahi A; Social Scientific Systems, Silver Spring, Maryland, USA.
  • Waymer T; Social Scientific Systems, Silver Spring, Maryland, USA.
  • Bolan RK; Los Angeles LGBT Center, Los Angeles, California, USA.
  • Philip SS; San Francisco Department of Public Health, San Francisco, California, USA.
  • Asbel LE; Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA.
  • Taylor SN; Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
  • Mena LA; University of Mississippi Medical Center, Oxford, Mississippi, USA.
  • Goldstein DA; Whitman Walker Health, Washington, D.C., USA.
  • Powell JA; The Emmes Company, Rockville, Maryland, USA.
  • Wierzbicki MR; The Emmes Company, Rockville, Maryland, USA.
  • Morris SR; Department of Medicine, University of California, San Diego, La Jolla, California, USA.
Clin Infect Dis ; 73(2): 298-303, 2021 07 15.
Article en En | MEDLINE | ID: mdl-32766725
BACKGROUND: Novel treatment strategies to slow the continued emergence and spread of antimicrobial resistance in Neisseria gonorrhoeae are urgently needed. A molecular assay that predicts in vitro ciprofloxacin susceptibility is now available but has not been systematically studied in human infections. METHODS: Using a genotypic polymerase chain reaction assay to determine the status of the N. gonorrhoeae gyrase subunit A serine 91 codon, we conducted a multisite prospective clinical study of the efficacy of a single oral dose of ciprofloxacin 500 mg in patients with culture-positive gonorrhea. Follow-up specimens for culture were collected to determine microbiological cure 5-10 days post-treatment. RESULTS: Of the 106 subjects possessing culture-positive infections with wild-type gyrA serine N. gonorrhoeae genotype, the efficacy of single-dose oral ciprofloxacin treatment in the per-protocol population was 100% (95% 1-sided confidence interval, 97.5-100%). CONCLUSIONS: Resistance-guided treatment of N. gonorrhoeae infections with single-dose oral ciprofloxacin was highly efficacious. The widespread introduction and scale-up of gyrA serine 91 genotyping in N. gonorrhoeae infections could have substantial medical and public health benefits in settings where the majority of gonococcal infections are ciprofloxacin susceptible. CLINICAL TRIALS REGISTRATION: NCT02961751.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Gonorrea Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Imprimir
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PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Gonorrea Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos