Goldstein A M, Clark J H, Wickler M A
Department of Urology, University of Southern California, School of Medicine, Los Angeles 90033.
Sex Transm Dis. 1991 Jul-Sep;18(3):180-2. doi: 10.1097/00007435-199107000-00011.
Penicillinase-producing strains of Neisseria gonorrhoeae account for an increasing percentage of cases of gonorrhea in the United States. Although many strains of N. gonorrhoeae are still sensitive to penicillin, the CDC currently recommends one dose of ceftriaxone 250 mg IM for treatment of uncomplicated urethral gonorrhea. Ceftizoxime like ceftriaxone is a third generation cephalosporin that demonstrates excellent MICs against beta-lactamase positive and negative strains of N. gonorrhoeae. The clinical efficacy of a single-dose of ceftizoxime 250 mg IM was compared with ceftriaxone 250 mg IM in patients with uncomplicated urethral gonorrhea. In addition, the cost of each regimen was evaluated to determine the most cost-effective agent. A total of 106 and 98 patients were treated with ceftizoxime and ceftriaxone, respectively, with all cases cured. PPNG strains were observed in 25.5% of patients. No adverse events were observed or reported. The cost of ceftizoxime was approximately one-third that of ceftriaxone ($2.37 to $2.56 and $7.15 to $8.70 per dose, respectively). The data from this study suggest that ceftizoxime 250 mg IM is a safe, cost-effective alternative to the use of ceftriaxone 250 mg IM in the treatment of patients with PPNG-positive and -negative gonorrhea.
在美国，产青霉素酶的淋病奈瑟菌菌株在淋病病例中所占比例日益增加。尽管许多淋病奈瑟菌菌株仍对青霉素敏感，但美国疾病控制与预防中心（CDC）目前推荐单次肌内注射250mg头孢曲松用于治疗单纯性尿道淋病。头孢唑肟与头孢曲松一样，是第三代头孢菌素，对产β-内酰胺酶和不产β-内酰胺酶的淋病奈瑟菌菌株均显示出优异的最低抑菌浓度（MIC）。对单纯性尿道淋病患者，比较了单次肌内注射250mg头孢唑肟与单次肌内注射250mg头孢曲松的临床疗效。此外，还评估了每种治疗方案的成本，以确定最具成本效益的药物。分别有106例和98例患者接受了头孢唑肟和头孢曲松治疗，所有病例均治愈。25.5%的患者中观察到产青霉素酶的淋病奈瑟菌（PPNG）菌株。未观察到或报告有不良事件。头孢唑肟的成本约为头孢曲松的三分之一（每剂分别为2.37美元至2.56美元和7.15美元至8.70美元）。这项研究的数据表明，在治疗PPNG阳性和阴性淋病患者时，单次肌内注射250mg头孢唑肟是一种安全、具有成本效益的替代单次肌内注射250mg头孢曲松的药物。
