Gonorrhea

Ceftriaxone 250 mg IM once or ciprofloxacin 500 mg p.o. once or norfloxacin 800 mg p.o. or cefuroxime axetil 1 g p.o. once plus probenecid 1 g or cefotaxime 1 g IM once or ceftizoxime 500 mg IM once plus Doxycycline 100 mg two times daily for 7 days or tetracycline 500 mg four times daily for 7 days 

Erythromycin base 500 mg PO four times daily for 7 days 

Ceftriaxone 1 g IM or IV every 24 hours or ceftizoxime 1 g IV every 8 hours or cefotaxime 1 g IV every 8 hours until all symptoms resolve 

Ceftriaxone 25-50 mg/kg IV or IM in a single daily dose for 7 days or cefotaxime 25 mg/kg IV or IM two times daily for 7 days 

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Gonorrhea. Gonorrhea, caused by Neisseriagonorrheae is the most commonly reported communicable disease in the United States. Approximately lO cases were reported to the Center for Disease Control (CDC) in 1979, but actual cases could be two to three times higher (99,100). In addition, an increasing number of strains are becoming resistant to penicillin, the antibiotic that is usually used to treat this disease. 

Tripper, m. clap, gonorrhea, -gift, n. gonorrheal virus. 

The natural and semi ynthetic penicillins are used in tire treatment of bacterial infections due to susceptible microorganisms. Fbnicillins may be used to treat infections such as urinary tract infections, septicemia, meningitis, intra-abdominal infection, gonorrhea, syphilis, pneumonia, and other respiratory infections. Examples of infectious microorganisms (bacteria) that may respond to penicillin therapy include gonococci, staphylococci,... 

Spectinomycin (Trobicin) is chemically related to but different from the aminoglycosides (see Chap. 10). This drug exerts its action by interfering with bacterial protein synthesis. Spectinomycin is used for the treatment of gonorrhea... 

This drug is contraindicated in known cases of hypersensitivity to spectinomycin. In addition, the drug should not be given to infants. If another sexually transmitted disease is present with gonorrhea, additional anti-infectives may be needed to eradicate the infectious processes. Safe use during pregnancy (Category B) or lactation or in children has not been established. 

Spectinomycin. Spectinomycin may be given as a single dose, but multiple doses may be prescribed for complicated, widespread gonorrhea. The nurse warns the patient tiiat the IM injection may be uncomfortable and tiiat soreness at die injection site may be noted for abrief time. The nurse emphasizes die importance of following die primary healtii care provider s recommendations... 

When giving spectinomycin to Mr. Jbckson for gonorrhea, the nurse advises him to. ... 

Before insertion, a complete medical and social history is performed, including Pap smear, gonorrhea, and Chlamydia culture, and tests for other sexually transmitted diseases. 

Erythromycin base (Ery-tab) Gonorrhea 500 mg orally four times daily for 7 days Second-line agent in pregnancy... 

During lactation, all CDC first-line recommended therapies for gonorrhea (Table 44-5) are deemed compatible with breast-feeding by the AAP.14 Quinolone therapy is not recommended for women residing in California or Hawaii due to the increasing numbers of quinolone-resistant species.38... 

Repeat culture for gonorrhea or chlamydia 3 weeks after completion of therapy... 

Topical antibiotic drops are preferred. Consider subconjunctival antibiotics if compliance is a concern. Systemic therapy is useful in cases of systemic infection (e.g., gonorrhea) or if the sclera is infected. Reserve ointments for minor cases or adjunctive nighttime therapy.19... 

When diagnosing and treating gonorrhea, assume co-infection with Chlamydia trachomatis treatment recommendations should cover both organisms. 

Several laboratory tests are available to aid in the diagnosis of gonorrhea and include gram-stained smears, culture, or the DNA hybridization probe. 

Gonorrhea is a curable STI caused by the gram-negative diplococcus Neisseria gonorrhoeae. Proper therapeutic management with antimicrobial agents is essential to eradicate this infection and prevent the development of associated sequelae. 

Unprotected sex is a major risk factor for contracting STIs and this patient s symptoms are consistent with gonorrhea, as purulent urethral discharge is suggestive of this infection. In addition, the incubation period is also evidence that the infection could be gonococcal. Infection with C. trachomatis is usually associated with a very watery discharge and this patient lacks the characteristic ulcerations commonly observed with other STIs such as syphilis and herpetic infection. 

Treatment of gonorrhea may vary according to clinical presentation and is indicated as follows ... 

C. trachomatis possesses characteristics resembling both bacteria and viruses. Its major membrane is comparable to that of gram-negative bacteria, although it lacks a peptidoglycan cell wall and requires cellular components from the host for replication. Chlamydia transmission risk is thought to be less than that of gonorrhea. 

Culture is usually positive for both chlamydia and gonorrhea. 

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