Therapy for Gonococcal Infections: Options in 1989

Moran, John S.; Zenilman, Jonathan M.

doi:10.1093/clinids/12.supplement_6.s633

Cited by 41 publications

(12 citation statements)

References 58 publications

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“…For example, as late as the 1980s tetracycline was used to treat sexually transmitted diseases. With the appearance of resistant strains of Neisseria gonorrhoeae, however, tetracycline has been discontinued as the first line of therapy (17,57,60). However, oxytetracycline and tetracycline are still used to treat nongonococcal urethritis and other chlamydial infections (106).…”

mentioning

confidence: 99%

Bacterial resistance to tetracycline: mechanisms, transfer, and clinical significance

1992

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Tetracycline has been a widely used antibiotic because of its low toxicity and broad spectrum of activity. However, its clinical usefulness has been declining because of the appearance of an increasing number of tetracycline-resistant isolates of clinically important bacteria. Two types of resistance mechanisms predominate: tetracycline efflux and ribosomal protection. A third mechanism of resistance, tetracycline modification, has been identified, but its clinical relevance is still unclear. For some tetracycline resistance genes, expression is regulated. In efflux genes found in gram-negative enteric bacteria, regulation is via a repressor that interacts with tetracycline. Gram-positive efflux genes appear to be regulated by an attenuation mechanism. Recently it was reported that at least one of the ribosome protection genes is regulated by attenuation. Tetracycline resistance genes are often found on transmissible elements. Efflux resistance genes are generally found on plasmids, whereas genes involved in ribosome protection have been found on both plasmids and self-transmissible chromosomal elements (conjugative transposons). One class of conjugative transposon, originally found in streptococci, can transfer itself from streptococci to a variety of recipients, including other gram-positive bacteria, gram-negative bacteria, and mycoplasmas. Another class of conjugative transposons has been found in the Bacteroides group. An unusual feature of the Bacteroides elements is that their transfer is enhanced by preexposure to tetracycline. Thus, tetracycline has the double effect of selecting for recipients that acquire a resistance gene and stimulating transfer of the gene.

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confidence: 99%

Bacterial resistance to tetracycline: mechanisms, transfer, and clinical significance

1992

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“…Quinolones, because of their 'in vitro' [25] and 'in vivo' [26] activity against Neisseria gonorrhoeae, are listed as therapeutic agents in the guidelines for the treatment of sexually transmitted diseases of the Center for Disease Control [26,27], However, due to their moder ate to insufficient activity against C. trachoma tis [25,[27][28][29][30], they are not recommended for the treatment of nongonococcal or mixed chlamydial-gonococcal infections [27][28][29][30]. Re cently, Wise et al [2] showed that rufloxacin is more active than ciprofloxacin against Chla mydia pneumoniae and less active against C. trachomatis.…”

Section: Discussionmentioning

confidence: 99%

In vitro Activity of Rufloxacin against <i>Listeria monocytogenes</i>, <i>Legionella pneumophila</i>, and Chlamydia trachomatis

Furneri

M²,

Campo³

et al. 1994

Chemotherapy

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The in vitro activity of a new fluorquinolone, rufloxacin, was determined against both clinical isolates and standard strains of Legionella pneumophila, Chlamydia trachomatis, and Listeria monocytogenes and compared to that of ciprofloxacin, ofloxacin, and erythromycin. Among the antibacterials tested erythromycin was the most active. Rufloxacin inhibited the growth of L. pneumophila at concentrations in the range of 0.06-0.25 mg/l, that of C. trachomatis at concentrations in the range of 2-4, and that of L. monocytogenes at concentrations in the range of 1-2 mg/l. Rufloxacin demonstrated approximately the same activity as ciprofloxacin against C. trachomatis, but twice as less potency as ofloxacin and erythromycin against L. pneumophila, L. monocytogenes, and C. trachomatis, and twice as less potency as ciprofloxacin against L. pneumophila.

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“…Cefotaxime, cefodizime, ceftriaxone and ciprofloxacin fulfill these requirements and have high efficacy as shown in Table 1 (11). In their current guidelines the Centers for Disease Control (CDC) therefore recommend use of these agents (12). Neisseria gonorrhoeae and Chlamydia trachomatis are often present simultaneously as infecting organisms in uncomplicated urethritis or cervicitis.…”

Section: New Antimicrobial Agents In Sexually Transmitted Infectionsmentioning

confidence: 99%

The value of new antimicrobial agents

Wagenvoort

1993

Eur. J. Clin. Microbiol. Infect. Dis.

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New antimicrobial agents require careful assessment to determine whether they possess the appropriate properties for clinical use. Many new compounds of value in the prophylaxis and therapy of infections have been included in the current armamentarium. Close monitoring to identify possible adverse effects of new agents is essential. Alternative uses of older agents also expands therapeutic opportunities in the combat against infectious diseases. Inappropriate use of antimicrobial agents contributes to the worldwide problem of increasing bacterial resistance. The dramatic spread of such bacterial strains is partially responsible for the rising costs of infectious diseases. A rational and strict antibiotic policy is thus of great importance for the optimal use of these agents.

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Therapy for Gonococcal Infections: Options in 1989

Cited by 41 publications

References 58 publications

Bacterial resistance to tetracycline: mechanisms, transfer, and clinical significance

Bacterial resistance to tetracycline: mechanisms, transfer, and clinical significance

In vitro Activity of Rufloxacin against <i>Listeria monocytogenes</i>, <i>Legionella pneumophila</i>, and Chlamydia trachomatis

The value of new antimicrobial agents

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