Neisseria infection, treatment

Chloroquine (Aralen) is also used in die treatment of extraintestinal amebiasis (see section on Amebicides). Doxycycline is also used to treat infections caused by Neisseria gonorrhoeae, Treponema pallidum, Listeria monocytogenes, Clostridium, and Bacillus anthracis when penicillin is contraindicated. Quinine also may be used for die prevention and treatment of nocturnal leg cramps. 

The treatment of bacterial infections of the central nervous system highlights a number of important therapeutic considerations. Bacterial meningitis is caused by a variety of bacteria although their incidence varies with age. In the neonate, E. coli and group B streptococci account for the majority of infections, while in the preschool child H. influenzae is the commonest pathogen. Neisseria meningitidis has a... 

Hyperacute bacterial conjunctivitis is associated with gonococcal infections in sexually active patients. The causative agents are Neisseria gonorrhoeae or N. meningitidis. Prompt work-up and treatment is required, as corneal perforation occurs in 10% of cases within 48 hours.12 An ophthalmologist should complete a conjunctival scraping and susceptibility testing.10... 

Clotrimazole is an imidazole antifungal agent indicated for the treatment of fungal infections caused by Candida albicans. The administration of clotrimazole would be of no use in the treatment of infections caused by Chlamydia trachomatis, Neisseria gonorrhoea, Staphylcoccus aureus and Streptococcus pneumoniae. 

Neisseria meningitidis carriers Treatment of asymptomatic carriers of N. meningitidis to eliminate meningococci from the nasopharynx. Not indicated for treatment of meningococcal infection. 

Acute salpingitis (pelvic inflammatory disease) due to Neisseria gonorrhoeae. Chlamydia trachomatis, or both is often complicated by superinfection with gramnegative bacilli and anaerobes. A combination of gentamicin, clindamycin, and doxycycline has been shown to be an effective treatment for this polymicrobial infection. 

Gram-negative Neisseria gonorrhoeae is within the spectrum of activity for penicillin G, but many strains of this organism produce penicillinase. Because antibiotic therapy is typically taken before bacterial susceptibilities are known, recommended drugs for treatment of gonococcal infections include the cephalosporins, ceftriaxone and cefixime, which are not inactivated by gonococcal penicillinase. 

Stamm WE, Guinan ME, Johnson C, Starcher T, Hohnes KK, McCormack WM. Effect of treatment regimens for Neisseria gonorrhoeae on simultaneous infection with Chlamydia trachomatis. N Engl J Med 1984 310 545-9. 

Buimer M, Bruisten S. Comparison between the LCx Probe system and the COBAS AMPLICOR system for detection of Chlamydia trachomatis and Neisseria gonorrhoeae infections in patients attending a clinic for treatment of sexually transmitted diseases in Amsterdam, The Netherlands. J Clin Microbiol 2001 39 829-35. 

Norfloxacin is a fluoroquinolone that interferes with microbial DNA synthesis. It is indicated as an oral treatment of urinary tract infections (UTIs) caused by susceptible organisms treatment of sexually transmitted diseases (STDs) caused by Neisseria gonorrhoeae ocular solution for treatment of superficial ocular infections due to strains of susceptible organisms and prostatitis caused by E. coli. 

Azithromycin has a similar spectmm of activity but is more active against H influenzae, M catarrhalis, and neisseria. Because of its long half-life, a single dose of azithromycin is effective in the treatment of urogenital infections due to C trachomatis, and a 4-day course of treatment has been effective in community-acquired pneumonia. 

Ampicillin is essentially equivalent to benzylpenicillin for pneumococcal, streptococcal, and meningococcal infections, and many strains of Gram-negative Salmonella, Shigella, Proteus mirabllls, and Escherichia coll, as well as many strains of Haemophilus influenzae and Neisseria gonorrhoeae, respond well to oral treatment with ampicillin. 

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