Stamm W E
Am J Med. 1987 Apr 27;82(4A):307-10.
Although most bacterial sexually transmitted diseases (STDs) can be effectively treated, currently available regimens are far from ideal. Increasingly widespread plasmid-mediated resistance to the penicillins limits the use of these agents in the treatment of Neisseria gonorrhoeae and Hemophilus ducreyi infections. Chromosomally mediated antimicrobial resistance to the tetracyclines, penicillins, erythromycins, and sulfonamides further limits therapeutic options in the treatment of gonorrhea, and plasmid-mediated resistance to sulfonamides and tetracyclines is frequent in H. ducreyi infections. In patients with Chlamydia trachomatis infections, effective regimens that can more easily be complied with (shorter duration, less frequent dosing) are needed, as are effective alternative regimens for use in pregnancy and in infants. In selected STDs that are polymicrobial (pelvic inflammatory disease and bacterial vaginosis, for example) or that often present simultaneously (gonorrhea-chlamydia, gonorrhea-syphilis, chancroid-syphilis), single-drug regimens that are effective against several genital pathogens would be ideal. Only limited therapeutic alternatives are available for some STDs, especially in pregnant women or in patients with penicillin allergy. Thus, antimicrobial resistance, drug toxicity, poor compliance, limited alternatives in pregnancy or allergy, and the lack of single agents possessing a broad spectrum of activity against multiple genital pathogens limit currently available therapy.
虽然大多数细菌性性传播疾病（STD）可以得到有效治疗，但目前可用的治疗方案远非理想。质粒介导的对青霉素的耐药性日益广泛，限制了这些药物在治疗淋病奈瑟菌和杜克雷嗜血杆菌感染中的应用。染色体介导的对四环素、青霉素、红霉素和磺胺类药物的抗菌耐药性进一步限制了淋病治疗中的治疗选择，并且在杜克雷嗜血杆菌感染中，质粒介导的对磺胺类药物和四环素的耐药性很常见。对于沙眼衣原体感染患者，需要更易于依从的有效治疗方案（疗程更短、给药频率更低），以及用于孕妇和婴儿的有效替代方案。在某些多微生物性的性传播疾病（例如盆腔炎和细菌性阴道病）或经常同时出现的疾病（淋病 - 衣原体、淋病 - 梅毒、软下疳 - 梅毒）中，对多种生殖病原体有效的单药治疗方案将是理想的。对于某些性传播疾病，尤其是孕妇或对青霉素过敏的患者，可用的治疗选择有限。因此，抗菌耐药性、药物毒性、依从性差、妊娠或过敏时的替代方案有限，以及缺乏对多种生殖病原体具有广泛活性的单一药物，限制了目前可用的治疗方法。
