RESUMO
Gonococcal conjunctivitis can be a severe disease with sequelae of corneal ulceration, hypopyon, and global perforation. Current recommended therapy is hospitalization and repeated courses of parenteral antibiotics. The authors report a case successfully managed with a single injection of the new third-generation cephalosporin, ceftriaxone.
Assuntos
Cefotaxima/análogos & derivados , Conjuntivite/tratamento farmacológico , Gonorreia/tratamento farmacológico , Infecção Laboratorial/tratamento farmacológico , Adulto , Cefotaxima/administração & dosagem , Cefotaxima/uso terapêutico , Ceftriaxona , Conjuntivite/microbiologia , Feminino , Humanos , Infecção Laboratorial/microbiologiaRESUMO
Therapy of disease caused by penicillinase-producing Neisseria gonorrhoeae with lower-than-standard doses of cefoxitin was evaluated. A pilot study showed that doses of greater than or equal to 1 g were adequate, whereas 500-mg doses consistently failed. After the pilot study, 89 men with gonorrhea were treated with 1 g of cefoxitin given intramuscularly plus 1 g of probenecid given orally. Of the 89 men, 86 were cured. Sixty per cent were infected with penicillin-resistant strains of N. gonorrhoeae. The three men who were culture-positive on follow-up had been sexually reexposed, whereas none of those with negative cultures had had reexposure. These clinical results indicate that a treatment regimen of 1 g of parenteral cefoxitin plus 1 g of oral probenecid appears to be as effective as the standard 2-g dose. Regimens using doses lower than 1 g are ineffective.
Assuntos
Cefoxitina/administração & dosagem , Gonorreia/tratamento farmacológico , Uretrite/tratamento farmacológico , Adolescente , Cefoxitina/uso terapêutico , Humanos , Masculino , Medicina Naval , Neisseria gonorrhoeae/enzimologia , Penicilinase/biossíntese , Projetos Piloto , Espectinomicina/uso terapêuticoRESUMO
Since cefoxitin has been shown to be an effective alternative to spectinomycin for the treatment of infections due to penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) its efficacy was compared with that of a new cephalosporin, ceftriaxone (R013-9904). One hundred and twenty eight men with culture-confirmed gonococcal urethritis were treated with either 250 mg of ceftriaxone intramuscularly or 2 g of cefoxitin intramuscularly with oral probenecid 1 g. The incidence of penicillin-resistant strains in each group was about 60%. Ceftriaxone was completely effective in treating both penicillin-sensitive and penicillin-resistant gonococcal urethritis. No side effects were noted. Ceftriaxone thus seems to be an effective and safe alternative to either spectinomycin or cefoxitin in the treatment of penicillin-resistant gonococcal urethritis.
