Treatment For Gonorrhea

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Gonorrhea is the second most commonly reported sexually transmitted diseases caused by a bacterium Neisseriae gonorrhoaea. It is characterized by thick discharge from the penis or vagina which is why it is known in other alternative nicknames as “clap” and “The drip”. The infection is transmitted during unprotected sexual contact. It can also infect the throat or mouth from oral sex and the rectum from anal penetration. Women with gonorrhea are at higher risk of miscarriage, preterm birth and uterine infection after delivery. The infection can be passed to the newborn affecting mostly the eyes leading to blindness. Gonorrhea is commonly asymptomatic among women until complications arise like pelvic inflammatory disease that can result to tubal scarring and may lead to infertility or ectopic pregnancy. In men, the infection can cause epididymitis (painful condition of the testicles).

Pharmacologic Management of Gonorrhea

Uncomplicated Gonorrhea

Cephalospirin antibiotics have been the foundation of treatment for gonorrhea. These drugs are a family of bactericidal antibiotics derived from the structural component of penicillin. It binds to the penicillin-binding proteins of bacteria. It works by inhibiting the synthesis of the bacterial wall causing breakdown thus preventing rapid growth. There has been no reported long term problem related to Gonorrhea if treatment is initiated early in the course of the infection.

Classifications of Cephalosphorins

First generation cephalosphorins

Acts against many gram-positive cocci.

  • Cefadroxil
  • Cephalexin
  • Cefazolin
  • cephradine

Second generation cephalosphorins

Have broader antibacterial activity against sensitive organisms such as neisseria, enterobacter and hemophilus influenza.

  • Cefoxitin
  • Cefuroxime
  • Cefaclor
  • Cefprozil
  • Cefonicid

Third generation cephalosphorins           

These are more active against gram negative organisms and less active gram-positive bacteria.

  • Cefixime
  • Cefotaxime
  • Ceftriaxone
  • Ceftazidime
  • Cefoperazone

Fourth generation cephalosphorins

Has the broadest spectrum of antibacterial activity which is active against both gram-positive and gram-negative organisms. These are highly active on nosocomial pathogens.

  • Cefepime
  • Cefluprenam
  • Cefozopran
  • Cefquinome

Fifth generation cephalosphorins

Also known as advanced generation cephalosphorins. They have a very wide range of anti-bacterial properties. These drugs are active against both gram-positive and gram-negative organisms including methicillin resistant Staphylococcus aureus (MRSA)

  • Ceftaroline
  • Ceftobiprole

Ceftriaxone in single dose of two hundred and fifty milligram given as injection is effective in treating uncomplicated gonorrhea. One week after treatment, retesting is recommended for evaluation of outcomes. It is important to remember to avoid sexual contact while being treated. Re-infection is possible if your sex partner is not tested and treated.

Antibiotic Resistant Gonorrhea

This is also referred as ‘sex superbugs’. It was easy treating gonorrhea before the emergence of resistant strains of gonorrhea. The common antibiotics used to treat the infection are no longer effective. In this case, a Gonorrhea culture is recommended to test for bacterial resistance to a particular antibiotic Center for Disease Control recommends dual therapy due to an increasing number of multidrug-resistant Gonorrhea which is a growing health concern. In fact, drug-resistant gonorrhea is one of the eighteen superbugs threatening mankind.

The following course of treatment aims to stop the infection but the permanent damage brought by the infection can no longer be repaired.

  • Ceftriaxone (single dose of two hundred and fifty milligram given as injection) in combination with one gram oral azithromax or one hundred milligram doxycycline taken orally twice a day for seven days.
  • Cefixime four hundred milligram (orally) and one gram oral azithromax or one hundred milligram doxycycline taken orally twice a day for seven days.

Similar to Penicillin, Cephalosphorins have side effects

  • Drug allergy and hypersensitivity
  • Hepatotoxic (drug-induced liver injury)
  • Diarrhea due to high biliary concentration of the drugs

Prevention is Better than Cure

  • Abstinence is the surest way to prevent gonorrhea.
  • Practicing safe sex.
  • Having only one sex partner.

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