cefotaxime and Chlamydia-Infections

Topics: Anti-Bacterial Agents; Azithromycin; Cefixime; Cefotaxime; Chlamydia Infections; Chlamydia trachomatis; Female; Gonorrhea; Humans; Male; Research Design; Sexually Transmitted Diseases, Bacterial

Topics: Administration, Oral; Anti-Infective Agents; Cefixime; Cefotaxime; Chlamydia Infections; Ciprofloxacin; Doxycycline; Female; Gonorrhea; Guidelines as Topic; Humans; Male; Ofloxacin; Randomized Controlled Trials as Topic

A review is given of the selection and rational of optimal treatment regimens for patients with sexually transmitted pathogens, e.g. in cases of gonorrhea, chlamydial infections, chancroid, syphilis, pelvic inflammatory diseases and ophthalmia neonatorum. The scientific basis for the selection of a beta-lactam agent is discussed, including dose, MIC, the critical serum level and maintenance interval, and the duration of therapy. Except in the case of penicillinase-producing Neiserria gonorrhoeae, penicillin remained until recently the most effective agent available against many sexually transmitted diseases. However, ceftriaxone, a new third-generation cephalosporin, has been shown to have a long half-life (8 h) and excellent in vitro efficacy against Neiserria gonorrhoeae (including penicillinase-producing strains) and Haemophilis ducreyi. In view of its exceptional clinical efficacy against both gonorrhea and chancroid, clinical studies of its efficacy against other sexually transmitted diseases appear warranted.

Topics: Anti-Bacterial Agents; Cefotaxime; Ceftriaxone; Cephalosporins; Chancroid; Chlamydia Infections; Female; Gonorrhea; Humans; Infant, Newborn; Male; Ophthalmia Neonatorum; Pelvic Inflammatory Disease; Penicillins; Sexually Transmitted Diseases; Syphilis; Time Factors; Urethritis

C-reactive protein (CRP), a biological marker of inflammation, may be a useful indicator of therapeutic response in patients with septic pelvis. In a study comparing ceftizoxime and cefoxitin/doxycycline in patients with septic pelvis, quantitative CRP levels were closely correlated with the responses and failures of therapy. The results of this study showed the two antibiotic regimens to be equally effective, with 23 of 25 patients in each treatment group achieving a satisfactory response. The fact that ceftizoxime was effective in four of five patients with Chlamydia trachomatis in cervical isolates suggests that intravenous therapy for the acute infection can be accomplished without the addition of an antichlamydial agent. Upon discharge from the hospital, patients can continue therapy with an oral drug that is specifically active against Chlamydia.

Topics: C-Reactive Protein; Cefotaxime; Cefoxitin; Ceftizoxime; Chlamydia Infections; Doxycycline; Drug Combinations; Female; Gonorrhea; Humans; Injections, Intravenous; Random Allocation; Salpingitis

Single-dose ceftriaxone, 125 mg given intramuscularly, was compared with spectinomycin 2.0 g given intramuscularly in the treatment of women with uncomplicated gonorrhea. Cervical or anorectal gonococcal infection was eradicated in 54 (98 percent) of 55 women treated with ceftriaxone and 22 (96 percent) of 23 treated with spectinomycin. Cure rates for pharyngeal gonococcal infections were nine of 10 for ceftriaxone and four of eight for spectinomycin (p = 0.18). Neither agent eradicated concurrent Chlamydia trachomatis infection. The geometric mean minimal inhibitory concentration for ceftriaxone was 0.0038 microgram/ml for 65 pretreatment cervical isolates of beta-lactamase-negative Neisseria gonorrhoeae and all isolates were inhibited by 0.063 microgram/ml. Neither drug caused perceptible toxicity, but patient acceptance was better for ceftriaxone than for spectinomycin. A single 125 mg dose of ceftriaxone is an excellent regimen in the treatment of uncomplicated gonorrhea in women.

Topics: Adolescent; Adult; Cefotaxime; Ceftriaxone; Chlamydia Infections; Chlamydia trachomatis; Female; Gonorrhea; Humans; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Spectinomycin