Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, Children's Health Service, Brisbane, Queensland, Australia.
J Antimicrob Chemother. 2012 Sep;67(9):2059-61. doi: 10.1093/jac/dks188. Epub 2012 May 17.
From a once easily treatable infection, gonorrhoea has evolved into a challenging disease, which in future may become untreatable in certain circumstances. International spread of extensively drug-resistant gonococci would have severe public health implications. It seems clear that under the current treatment pressure from extended-spectrum cephalosporins, and owing to Neisseria gonorrhoeae's remarkable evolutionary adaptability, further rise of ceftriaxone-resistant strains around the world is inevitable. Simply increasing the doses of extended-spectrum cephalosporins will likely prove ineffective in the long run, and has been a lesson learnt for all single-agent therapies used for gonorrhoea to date. We recommend that dual therapy, especially those consisting of extended-spectrum cephalosporins and azithromycin, be adopted more widely and complemented by strengthening of antimicrobial resistance surveillance. Unless there is urgent action at international and local levels to combat the problem of N. gonorrhoeae antimicrobial resistance, we are in for gloomy times ahead in terms of gonorrhoea disease and control.
从一种曾经容易治疗的感染，淋病已经演变成一种具有挑战性的疾病，在某些情况下，它将来可能无法治疗。广泛耐药淋病奈瑟菌的国际传播将对公共卫生产生严重影响。目前，由于广泛使用头孢菌素类药物治疗淋病，而且由于淋病奈瑟菌具有显著的进化适应性，在全球范围内，头孢曲松耐药菌株的进一步上升是不可避免的。从长远来看，单纯增加头孢菌素类药物的剂量可能证明是无效的，这是迄今为止所有用于治疗淋病的单一药物治疗的一个教训。我们建议更广泛地采用联合治疗，特别是那些由头孢菌素类药物和阿奇霉素组成的联合治疗，并通过加强抗菌药物耐药性监测来补充。除非在国际和地方各级采取紧急行动来解决淋病奈瑟菌抗菌药物耐药性问题，否则我们将面临淋病疾病控制的黯淡未来。
