MMWR Morb Mortal Wkly Rep. 2018 Apr 27;67(16):473-476. doi: 10.15585/mmwr.mm6716a4.
Gonorrhea, the sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, is the second most common notifiable disease in the United States after chlamydia; 468,514 cases were reported to state and local health departments in 2016, an increase of 18.5% from 2015 (1). N. gonorrhoeae has progressively developed resistance to most antimicrobials used to treat the infection (2). As a result, CDC recommends two antimicrobials (250 mg of ceftriaxone [IM] plus 1 g of azithromycin [PO]) for treating uncomplicated gonorrhea to improve treatment efficacy and, potentially, to slow the emergence and spread of antimicrobial resistance. To monitor adherence to the current CDC-recommended regimen for uncomplicated gonorrhea, CDC reviewed enhanced data collected on a random sample of reported cases of gonorrhea in seven jurisdictions participating in the STD Surveillance Network (SSuN) and estimated the proportion of patients who received the CDC-recommended regimen for uncomplicated gonorrhea, by patient characteristics and diagnosing facility type. In 2016, the majority of reported patients with gonorrhea (81%) received the recommended regimen. There were no differences in the proportion of patients receiving the recommended regimen by age or race/ethnicity; however, patients diagnosed with gonorrhea in STD (91%) or family planning/reproductive health (94%) clinics were more likely to receive this regimen than were patients diagnosed in other provider settings (80%). These data document high provider adherence to CDC gonorrhea treatment recommendations in specialty STD clinics, indicating high quality of care provided in those settings. Local and state health departments should monitor adherence with recommendations in their jurisdictions and consider implementing interventions to improve provider and patient compliance with gonorrhea treatment recommendations where indicated.
淋病，一种由淋病奈瑟菌引起的性传播疾病（STD），是美国继衣原体之后第二大常见的法定传染病；2016 年，向州和地方卫生部门报告了 468,514 例病例，比 2015 年增加了 18.5%（1）。淋病奈瑟菌对抗生素的耐药性逐渐增强，用于治疗淋病的大多数抗生素都出现了耐药性（2）。因此，CDC 推荐两种抗生素（肌内注射 250 毫克头孢曲松加口服 1 克阿奇霉素）用于治疗单纯性淋病，以提高治疗效果，可能减缓抗生素耐药性的出现和传播。为了监测是否遵循 CDC 目前推荐的单纯性淋病治疗方案，CDC 对参与性传播疾病监测网络（SSuN）的七个司法管辖区报告的淋病病例的随机样本进行了审查，评估了根据患者特征和诊断机构类型，接受 CDC 推荐的单纯性淋病治疗方案的患者比例。2016 年，报告的淋病患者中，大多数（81%）接受了推荐方案。患者年龄或种族/族裔对接受推荐方案的比例没有差异；然而，在 STD（91%）或计划生育/生殖健康（94%）诊所诊断出淋病的患者比在其他医生诊疗机构（80%）更有可能接受该方案。这些数据表明，在专门的 STD 诊所，提供者高度遵循 CDC 淋病治疗建议，表明在这些环境中提供了高质量的护理。地方和州卫生部门应监测其管辖范围内的建议遵守情况，并考虑在有需要的情况下实施干预措施，以提高提供者和患者对淋病治疗建议的遵守率。
