Bowie W R, Ast J, Sibau L, Shaw C, Jones H D, Black W A
Divisions of Infectious Disease and Medical Microbiology, Faculty of Medicine, University of British Columbia; and the Division of Venereal Disease Control and the British Columbia Centre for Disease Control, Ministry of Health, British Columbia.
Can J Infect Dis. 1993 Nov;4(6):347-51. doi: 10.1155/1993/613963.
Men and women with gonorrhea or contact to gonorrhea are frequently co-infected with Chlamydia trachomatis. To assess the importance of using treatment regimens active against both Neisseria gonorrhoeae and C trachomatis, tetracycline 500 mg orally four times daily for five days, with activity against both organisms, was compared with ceftriaxone, 250 mg once intramuscularly, with activity against only N gonorrhoeae. N gonorrhoeae microbiological failure occurred in six of 148 patients (4%) on tetracycline and zero of 85 on ceftriaxone. Microbiological failure for C trachomatis occurred in zero of 27 on tetracycline and 10 of 12 (83%) on ceftriaxone (P<0.001). In addition, 14 others on ceftriaxone had C trachomatis first isolated after treatment. When all types of microbiologialc and clinical failures are included, outcome was significantly better on tetracycline (P<0.001). Optimal treatment of patients with gonorrhea must include regimens with activity against both C trachomatis and N gonorrhoeae.
患有淋病或接触过淋病的男性和女性常常同时感染沙眼衣原体。为评估使用对淋病奈瑟菌和沙眼衣原体均有效的治疗方案的重要性，将每日口服4次、每次500毫克四环素、连用5天（对两种病原体均有活性）与单次肌内注射250毫克头孢曲松（仅对淋病奈瑟菌有活性）进行了比较。在接受四环素治疗的148例患者中，有6例（4%）出现淋病奈瑟菌微生物学治疗失败，而在接受头孢曲松治疗的85例患者中，该比例为零。接受四环素治疗的27例患者中，沙眼衣原体微生物学治疗失败的比例为零，而接受头孢曲松治疗的12例患者中有10例（83%）出现失败（P<0.001）。此外，接受头孢曲松治疗的另外14例患者在治疗后首次分离出沙眼衣原体。当将所有类型的微生物学和临床治疗失败都纳入考虑时，四环素治疗的结果明显更好（P<0.001）。淋病患者的最佳治疗方案必须包括对沙眼衣原体和淋病奈瑟菌均有活性的治疗方案。
