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淋病无症状接触者的经验性治疗:患者观点。

Empirical treatment of asymptomatic contacts of gonorrhoea: patient views.

机构信息

Sydney Sexual Health Centre, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia; and Corresponding author. Email:

School of Public Health and Community Medicine, UNSW, High Street, Kensington, NSW 2052, Australia.

出版信息

Sex Health. 2020 Nov;17(5):462-466. doi: 10.1071/SH20072.

Abstract

UNLABELLED

Background The prevalence of Neisseria gonorrhoeae (gonorrhoea) in sexual contacts of gonorrhoea has not been established, but limited data suggest that the majority of contacts are not infected. Contacts of gonorrhoea who receive empirical treatment at the point of testing may receive unnecessary antimicrobial treatment for an infection that is known to have multidrug resistance. This study evaluated patient acceptability of non-empirical treatment.?

METHODS

We conducted an anonymous cross-sectional survey of patients attending sexual health centres in New South Wales, Australia, on the acceptability of empirical and non-empirical treatment models and patients' concerns about antimicrobial resistance.

RESULTS

Most of the 823 survey participants were willing to wait for treatment until their results were reported; 77% and 53% would agree to wait for treatment if results were available in 2 and 7 days respectively. Participants were less likely to agree to non-empirical treatment if they lived in regional and remote areas compared with those in a major city (odds ratio (OR) 0.5; 95% confidence interval (CI) 0.35-0.73). Most participants (70%) were worried about infections becoming resistant to antibiotics, with heterosexual men and women being less likely than gay and bisexual men to be worried (heterosexual men: OR 0.64, 95% CI 0.44-0.94; women: OR 0.64 95%, CI 0.44-0.92).

CONCLUSIONS

Non-empirical treatment was acceptable to most participants, but patient preference, ability to return for treatment and timeliness of results are factors that should inform individual treatment decisions.

摘要

背景

淋病奈瑟菌(淋病)在淋病接触者中的流行情况尚不清楚,但有限的数据表明,大多数接触者并未感染。在检测点接受经验性治疗的淋病接触者可能会接受不必要的抗菌治疗,因为已知这种感染具有多种药物耐药性。本研究评估了患者对非经验性治疗的接受程度。

方法

我们对澳大利亚新南威尔士州性健康中心的患者进行了一项匿名横断面调查,评估了他们对经验性和非经验性治疗模式的接受程度,以及患者对抗菌药物耐药性的担忧。

结果

在 823 名调查参与者中,大多数人愿意等待检测结果报告后再接受治疗;如果 2 天和 7 天内可获得检测结果,分别有 77%和 53%的人会同意等待治疗。与居住在主要城市的参与者相比,居住在偏远地区的参与者更不愿意接受非经验性治疗(比值比(OR)0.5;95%置信区间(CI)0.35-0.73)。大多数参与者(70%)担心感染会对抗生素产生耐药性,异性恋男性和女性比男同性恋和双性恋男性更不容易担心(异性恋男性:OR 0.64,95%CI 0.44-0.94;女性:OR 0.64,95%CI 0.44-0.92)。

结论

大多数参与者可以接受非经验性治疗,但患者的偏好、能否返回治疗以及结果的及时性是影响个体化治疗决策的因素。

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