Treatment of Uncomplicated Gonococcal Infection with Trime thoprim-Sul fame thoxazole

Brown, Stuart T.; Thompson, Sumner E.; Biddle, James W.; Kraus, Stephen J.; Zaidi, Akbar A.; Kleris, George S.

doi:10.1097/00007435-198201000-00002

Cited by 10 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[24][25][26][27] In 1988, a study of 119 patients with pharyngeal gonorrhoea found cure rates of 97% with a five-day schedule and 89.8% with a two-day schedule. 28 Failure was seen with MICs ≥0.5 mg/L of trimethoprim and ≥9.5 mg/L sulfamethoxazole, 29 whereas cure was predictable when the isolates were inhibited by ≤0.63/11.87 mg/L of TMP/SMZ (fixed ratio, 1:19). 30 Considering the EUCAST ECOFF of 8 mg/L (with respect to sulfamethoxazole); 72/93 of the present isolates, including those with the highest-levels of ceftriaxone resistance were inhibited, suggesting potential, though a significant minority would remain resistant if this was used as a clinical breakpoint.…”

Section: Discussionmentioning

confidence: 99%

What’s left in the cupboard? Older antimicrobials for treating gonorrhoea

Fifer

Livermore

Uthayakumaran

et al. 2021

Journal of Antimicrobial Chemotherapy

View full text Add to dashboard Cite

Background Neisseria gonorrhoeae has developed resistance to all antimicrobials used to treat gonorrhoea, with even ceftriaxone being undermined. It is therefore important to examine any potential to redeploy older antimicrobials routinely used for other infections to treat ceftriaxone-resistant gonococcal infections. Objectives We examined the susceptibility of N. gonorrhoeae to aztreonam, chloramphenicol, co-trimoxazole, fosfomycin, piperacillin/tazobactam and rifampicin. Methods N. gonorrhoeae isolates (n = 94) were selected to include a range of antimicrobial susceptibilities: 58 were collected in the Gonococcal Resistance to Antimicrobials Surveillance Programme; 17 were clinical isolates referred to the PHE reference laboratory; and 19 were control strains. MICs were determined by agar dilution for the six study antimicrobials and for ceftriaxone and azithromycin as comparators. Results There was correlation between piperacillin/tazobactam and ceftriaxone MICs, but all five isolates with high ceftriaxone MICs (>0.5 mg/L) were inhibited by piperacillin/tazobactam at 0.06–0.5 mg/L. Aztreonam MICs for ceftriaxone-resistant isolates exceeded those of ceftriaxone. Among non-β-lactams, fosfomycin and co-trimoxazole had low, tightly clustered MICs, suggesting widespread susceptibility, rifampicin split the collection into highly susceptible and highly resistant groups and chloramphenicol had a wide MIC distribution. Conclusions Although unsuitable for empirical use, piperacillin/tazobactam, fosfomycin, co-trimoxazole, rifampicin and, possibly, chloramphenicol could be considered for individual patients with ceftriaxone-resistant gonococcal infection once MICs are known. Wider surveillance of the susceptibility of N. gonorrhoeae to these agents is needed, along with clinical trials and the establishment of clinical breakpoints for N gonorrhoeae.

show abstract