For males who’ve intercourse with males and are recognized with extragenital Neisseria gonorrhoeae an infection, high-dose ceftriaxone monotherapy was discovered to be as efficient as twin remedy with azithromycin or doxycycline, in accordance with outcomes of a research revealed in Scientific Infectious Ailments.
Research members had been enrolled from a cohort of males who’ve intercourse with males examined for N gonorrhoeae/Chlamydia trachomatis each 3 months in a single-center observational research in Tokyo, Japan. Contributors older than 19 years who had been recognized with extragenital N gonorrhoeae an infection between 2017 and 2020 had been included and obtained a single 1-g dose of intravenous ceftriaxone monotherapy. For these recognized with a C trachomatis coinfection, twin remedy with a single 1-g dose of azithromycin or doxycycline 100 mg taken orally twice day by day for 7 days was administered.
A complete of 320 circumstances had been recognized; 208 had been handled with monotherapy, and 112 had been handled with twin remedy. Within the monotherapy group, efficacy towards whole, pharyngeal, and rectal infections was 98.1% (95% CI, 95.2-99.3), 97.8% (95% CI, 93.8-99.4), and 98.6% (95% CI, 92.3-99.9), respectively. Within the twin remedy group, efficacy was 95.5% (95% CI, 90.0-98.1) towards whole an infection, 96.1% (95% CI, 86.8-99.3) towards pharyngeal an infection, and 95.1% (95% CI, 86.5-98.7) towards rectal an infection. There was no important distinction in corresponding efficacy between teams for whole (P =.29), pharyngeal (P =.61), or rectal (P =.34) infections. A complete of 9 circumstances failed therapy, of which 3 had been efficiently cultured and no resistant mutations to ceftriaxone had been detected. Among the many circumstances by which therapy failed, the proportions of monotherapy or twin remedy and rectal and pharyngeal infections had been related.
The researchers report a number of research limitations, together with the lack to regulate the pattern measurement as a result of observational nature of the research, the intravenous dose of 1 g ceftriaxone being one of many highest really helpful and completely different from not too long ago really helpful therapies, and the selection of doxycycline because the second agent resulting from excessive ranges of resistance in N gonorrhoeae.
In line with the research authors, though the outcomes of this research confirmed the same efficacies of monotherapy and twin remedy choices in a real-world setting, there may be nonetheless a necessity for randomized managed trials to make clear the efficacy of those therapy choices in settings the place resistance to ceftriaxone is a priority.
Disclosure: Some research authors declared affiliations with biotech, pharmaceutical, and/or machine corporations. Please see the unique reference for a full listing of authors’ disclosures.
Aoki T, Mizushima D, Takano M, et al. Efficacy of 1g ceftriaxone monotherapy in comparison with twin remedy with azithromycin or doxycycline for treating extragenital gonorrhea amongst males who’ve intercourse with males. Clin Infect Dis. Revealed on-line Could 17, 2021. doi: 10.1093/cid/ciab455