ro13-9904 and Genital-Diseases--Male

We conducted a randomized, unblinded, prospective study designed to determine the efficacy of single-dose azithromycin for the treatment of chancroid. Men and women 16 years of age and older who had darkfield-negative genital ulcers that were clinically suspected to be caused by Haemophilus ducreyi and who attended urban sexually transmitted disease clinics or presented to hospital emergency departments were enrolled in the study. Patients were randomized to receive 250 mg of ceftriaxone im or 1 g of azithromycin orally, both given as a single dose. They were followed for up to 23 days after treatment. For 65 patients, cultures were positive for H. ducreyi; there were 68 patients whose cultures were negative for both H. ducreyi and herpes simplex virus and who had no evidence of syphilis. All 133 patients returned for at least one follow-up visit. At the time of the last follow-up visit, all 32 patients whose cultures were positive for H. ducreyi and who were treated with azithromycin were clinically cured. In all 33 culture-positive cases in which ceftriaxone was used, there was either clinical improvement or cure at the time of the patient's last follow-up visit. In addition, azithromycin and ceftriaxone were equally effective in healing ulcers for which cultures were negative. We conclude that a single 1-g oral dose of azithromycin is as effective as a 250-mg im dose of ceftriaxone for the treatment of chancroid.

Topics: Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Ceftriaxone; Cephalosporins; Chancroid; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Injections, Intramuscular; Male; Prospective Studies; Treatment Outcome; Ulcer

Topics: Adult; Ceftriaxone; Cefuroxime; Cellulitis; Diagnosis, Differential; Drug Therapy, Combination; Eye Infections, Bacterial; Genital Diseases, Male; Gonorrhea; Humans; Keratoconjunctivitis; Male; Neisseria gonorrhoeae; Orbital Diseases

Topics: Anti-Bacterial Agents; Azithromycin; Breast Feeding; Ceftriaxone; Chancroid; Ciprofloxacin; Contraindications; Erythromycin; Female; Genital Diseases, Female; Genital Diseases, Male; Haemophilus ducreyi; Humans; Male; Pregnancy; Pregnancy Complications, Infectious; Ulcer

Topics: Anti-Bacterial Agents; Cefoxitin; Ceftriaxone; Ciprofloxacin; Clindamycin; Contact Tracing; Female; Genital Diseases, Male; Humans; Male; Ofloxacin; Pelvic Inflammatory Disease; Peritonitis; Pregnancy; Pregnancy Complications, Infectious; Sexually Transmitted Diseases

Topics: Adult; Ceftriaxone; Cephalosporins; Debridement; Fournier Gangrene; Genital Diseases, Male; Humans; Hyperbaric Oxygenation; Male; Scrotum

To determine the effectiveness of intramuscular (IM) ceftriaxone sodium in the treatment of chronic donovanosis, and the acceptability to patients and staff of supervised outpatient treatment in rural clinics.. We collected demographic and sexual health data from participants using a standard questionnaire, and recorded their donovanosis lesions at baseline using genital diagrams. Treatment consisted of a single daily IM injection of 1 g ceftriaxone diluted in 2 ml of 1% lignocaine. Clinic staff followed patients for between three and 12 months, enabling the detection of late recurrences.. Rural Aboriginal communities in central Australia.. The study describes eight women and four men with chronic donovanosis in detail, and summarises the outcome in 12 additional cases. All cases presented with advanced lesions which had failed to heal on the standard oral antibiotic regimens used in the region.. The mean duration of infection was 3.0 years (SD 1.9 years), and between four and ten courses of antibiotics had been prescribed for six of the 12 patients. Patients received between 7-26g of ceftriaxone sodium. Clinical improvement was dramatic in most lesions, and four patients healed completely without recurrence after a total 7-10g of ceftriaxone. Mild recurrences responded to further ceftriaxone or short courses of oral antibiotics. Treatment was well tolerated, and both patient and staff compliance high.. Donovanosis is an important cause of chronic genital ulceration in central Australia, and is potentially an important risk factor for HIV transmission in Aboriginal communities. The pharmacokinetics and safety profile of ceftriaxone make it a useful and cost-effective agent in the ambulatory management of donovanosis, especially in remote communities. Supervised multidrug regimens of two or more long-acting agents may provide the best answer in donovanosis, administered through the existing health care infrastructure.

Topics: Adult; Australia; Ceftriaxone; Chronic Disease; Female; Genital Diseases, Female; Genital Diseases, Male; Granuloma Inguinale; Humans; Injections, Intramuscular; Male; Middle Aged; Recurrence

The efficacy of ceftriaxone 250 mg given as a single intramuscular dose to treat genitourinary and pharyngeal gonorrhoea is compared with the outcome of the Danish standard treatment for uncomplicated genitourinary gonorrhoea, pivampicillin 1.4 g and probenecid 1 g, both given by mouth. The study comprised 327 patients for whom the diagnosis of gonorrhoea was made by microscopy of a methylene blue stained smear at their first visit to the clinic and for whom the diagnosis was later confirmed by culture of Neisseria gonorrhoeae. One hundred and seventy patients with genitourinary gonorrhoea (18 with and 152 without concomitant pharyngeal infection) were treated with ceftriaxone. One hundred and fifty seven (17 with and 140 without concomitant pharyngeal infection) were treated with pivampicillin. One week after treatment N gonorrhoeae was isolated from none of 18, 1/152, (1%), 11/17 (65%), and 6/140 (4%) patients, respectively. At a second attendance two weeks after treatment no further treatment failure was found. During the study period, a further 52 patients with pharyngeal infection (with or without concomitant genitourinary infection) that was shown by culture only were treated with a single intramuscular injection of 250 mg ceftriaxone. No treatment failure was observed in this group. Only minor adverse drug reactions were seen. Ceftriaxone 250 mg as a single intramuscular injection is therefore safe and effective in treating gonorrhoea, including pharyngeal infection.

Topics: Adolescent; Adult; Aged; Ceftriaxone; Female; Genital Diseases, Female; Genital Diseases, Male; Gonorrhea; Humans; Injections, Intramuscular; Male; Middle Aged; Pharyngeal Diseases; Urinary Tract Infections