Antibiotic Chemotherapy of Bacterial Sexually Transmitted Diseases in Adults: A Review

Abstract

Treatment regimens for sexually transmitted infections continue to evolve. The natural history of syphilis in HIV-infected patients is leading to more aggressive policies in terms of both investigation and treatment. In particular, treatment protocols for late syphilis, especially neurosyphilis, are under scrutiny. Epidemiological change typified by the spread of penicillinase-producing Neisseria gonorrhoeae (PPNG) has led to a search for new agents to treat gonorrhoea, with a more extensive use of cephalosporin and quinolone antibiotics emerging. The problem of compliance with the antibiotic courses presently required for chlamydial infection may be close to being solved with the development of newer macrolide agents. Single dose azithromycin, although expensive, seems to be as effective as longer courses with other agents. Furthermore, its efficacy in gonococcal infection is also encouraging. Increased understanding of the pathogenesis and natural history of pelvic inflammatory disease (PID) and bacterial vaginosis (BV) has led to rationalization of treatment policies for these conditions.

New ideas/viewpoints

“…For example, gonorrhea has been associated with increased chances of Downloaded by [Umeå University Library] at 01:03 18 November 2014 Social Biology having still-births, prematurity (low birth weight, hence increased morbidity), prolonged labor, and spontaneous abortion (Aiken, 1992;Brunham, Holmes, and Embree, 1990;Corcoran and Ridgway, 1994;Westrom, 1991) as well as a whole range of other neonatal problems: opthalmia, conjunctivitis, pneumonia, arthritis (Gutman and Wilfert, 1990). Or, in the succinct terms of Gerbase et al (1998;p.…”

Sexually Transmitted Disease and Gender Roles

“…Gonorrhea, a cause of PID, has also been associated with increased chances of having stillbirths, prematurity (low birth weight, hence increased morbidity), prolonged labor, and spontaneous abortion (Brunham, Holmes, & Embree, 1990;Corcoran & Ridgway, 1994;Weström, 1991). In addition, the infectious agents, for example, chlamydia and gonorrhea, that cause PID also create a whole range of other neonatal problems: opthalmia, conjunctivitis, pneumonia, and arthritis (Gutman & Wilfert, 1990).…”

Pair-Bonding and the Evolutionary Trajectory of Homo: Disease Avoidance as an Adaptive Trait

“…Gonorrhea, a cause of PID, has also been associated with increased chances of having stillbirths, prematurity (low birth weight, hence increased morbidity), prolonged labor, and spontaneous abortion (Brunham, Holmes, and Embree 1990;Corcoran and Ridgway 1994;Weström 1991). In addition, the infectious agents (e.g., chlamydia and gonorrhea) which cause PID also create a whole range of other neonatal problems: opthalmia, conjunctivitis, pneumonia, and arthritis (Gutman and Wilfert 1990).…”