1Ĭomplicated gonococcal infections are much rarer than uncomplicated infections and may lead to serious conditions, such as septic arthritis, endocarditis, and/or meningitis. 1 Patients with uncomplicated N gonorrhoeae pharyngeal infections do not require a test of cure if they are treated with ceftriaxone and azithromycin however, if an alternative regimen is used, the patient should return to the physician’s office 14 days after therapy to receive a test of cure. Patients with uncomplicated gonococcal infections of the cervix, urethra, and/or rectum do not require a follow-up test of cure if they are treated with a recommended first-line or alternative regimen. Clinical trials showed that the treatment of pharyngeal infections with ceftriaxone resulted in a cure rate of 98.9%. 1 The CDC currently recommends that patients with uncomplicated gonococcal infections of the pharynx be treated with a regimen consisting of a single dose of ceftriaxone 250 mg IM in addition to a single oral dose of azithromycin 1 g. To help prevent the spread of infection, the CDC recommends that all sexually active women aged 90% of infections are achieved by very few antibiotic regimens. Other risk factors include inconsistent condom use while engaging in sexual contact with nonmonogamous partners previous history of N gonorrhoeae infection and trading sex for money, drugs, or other items. Risk factors for N gonorrhoeae include sexual contact with new or multiple partners, sexual contact with an individual who has concurrent partners, and sexual contact with a person who is currently infected with N gonorrhoeae. An N gonorrhoeae infection that results in bacteremia and/or the spread of bacteria to joints and tissues is considered a complicated infection. Uncomplicated infections are much more common, encompassing any urogenital, anogenital, or pharyngeal infection caused by N gonorrhoeae that does not result in bacteremia. N gonorrhoeae infections may be classified as either uncomplicated or complicated. 2 This increase is primarily due to an upsurge in the number of males who contracted N gonorrhoeae. 1 From 2010 to 2014, the national rate of reported N gonorrhoeae infection increased 10.5%, from 100.2 cases to 110.7 cases per 100,000 people ( FIGURE 1).
1 The CDC estimates that >800,000 new cases of N gonorrhoeae infection occur every year in the United States. Neisseria gonorrhoeae is the second most common communicable disease in the United States, behind Chlamydia trachomatis.
Multidrug-resistant gonorrhea is becoming a serious health threat in the U.S. The CDC currently recommends dual treatment with ceftriaxone and azithromycin for most gonococcal infections. As a result, the use of these agents has decreased. Similarly, fluoroquinolone-resistant strains of N gonorrhoeae have been reported. Cefixime, which was once the first-line agent for the treatment of Neisseria gonorrhoeae, is rapidly waning in efficacy, as are several other cephalosporins.
From 2010 to 2014, the rate of this sexually transmitted disease increased by 10.5% in the U.S. ABSTRACT: Gonorrhea is the second most common communicable disease in the United States.
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