Điều trị Lậu cầu

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ĐIỀU TRỊ LẬU CẦU
Phạm Đăng Trọng Tường





CEFIXIME
 A 400-mg oral dose of cefixime: Cured
 97.5% of uncomplicated urogenital and anorectal infections
 92.3% of pharyngeal infections
 Providers should inquire:
 Oral sexual exposure

Treat these patients with ceftriaxone: well documented
efficacy in pharyngeal infection.
OTHER CEPHALOSPORIN REGIMENS
 Single-dose injectible cephalosporin regimens that are
safe and highly effective:
 Ceftizoxime (500 mg, IM)
 Cefoxitin (2 g, IM with probenecid 1 g orally)
 Cefotaxime (500 mg, IM).
 None of the injectible cephalosporins:
 Any advantage over ceftriaxone for urogenital infection

Efficacy for pharyngeal infection is less certain
AZITHROMYCIN 2 G
 Effective against uncomplicated infection (99.2%)
 Azithromycin 1 g meets alternative regimen criteria (97.6%)
 Not recommended because of treatment failures
 Concerns about possible emergence of antimicrobial resistance
 Not adequately susceptible to penicillins, tetracyclines, and
older macrolides (e.g., erythromycin).

SPECTINOMYCIN
 Useful in persons who cannot tolerate cephalosporins
 Curing 98.2% of uncomplicated urogenital and anorectal infections
 Poor efficacy against pharyngeal infection (51.8%)
 Expensive, not available in the United States.
OTHERS
 Cefpodoxime 400mg orally:
 Some evidences: an alternative treatment
 Pharyngeal site: poor
 Cefuroxime axetil 1 g orally:
 Pharmacodynamics: less favorable than cefpodoxime,
cefixime, or ceftriaxone
 Minimum efficacy as an alternative regimen

Treating pharyngeal infection is poor (56.9%)

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