Moran J S, Levine W C
Division of STD/HIV Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333, USA.
Clin Infect Dis. 1995 Apr;20 Suppl 1:S47-65. doi: 10.1093/clinids/20.supplement_1.s47.
Resistance of Neisseria gonorrhoeae to antimicrobial agents continues to spread and intensify. Choosing an antimicrobial regimen requires knowledge of the comparative efficacy of candidate regimens, as delineated in properly conducted clinical trials; their activity against N. gonorrhoeae in vitro; and their pharmacokinetics and toxicity. We tabulated the results of trials of single-dose antimicrobial therapy for uncomplicated gonococcal infection published after 1980. Thirty regimens comprising 21 antimicrobial drugs have been shown to be highly effective for rectal and urogenital infections; the agents involved are cefixime, cefodizime, cefotaxime, cefoxitin, ceftizoxime, ceftriaxone, cefuroxime, cefuroxime axetil, ciprofloxacin, fleroxacin, norfloxacin, ofloxacin, pefloxacin, temafloxacin, azithromycin, aztreonam, netilmicin, rifampin plus erythromycin stearate, sisomicin, and spectinomycin. Few regimens have been shown to be highly effective against pharyngeal infections. Among those antimicrobial agents available for the treatment of uncomplicated gonococcal infections in the United States, ceftriaxone (125 mg), cefixime (400 mg), ciprofloxacin (500 mg), and ofloxacin (400 mg) appear to offer the best balance of proven efficacy and safety.
淋病奈瑟菌对抗菌药物的耐药性持续蔓延且不断加剧。选择抗菌治疗方案需要了解在恰当开展的临床试验中所描述的候选方案的相对疗效；它们在体外对淋病奈瑟菌的活性；以及它们的药代动力学和毒性。我们将1980年以后发表的关于单纯性淋菌感染单剂量抗菌治疗试验的结果制成表格。已证明30种方案（包含21种抗菌药物）对直肠和泌尿生殖系统感染高度有效；涉及的药物有头孢克肟、头孢地嗪、头孢噻肟、头孢西丁、头孢唑肟、头孢曲松、头孢呋辛、头孢呋辛酯、环丙沙星、氟罗沙星、诺氟沙星、氧氟沙星、培氟沙星、替马沙星、阿奇霉素、氨曲南、奈替米星、利福平加硬脂酸红霉素、西索米星和大观霉素。很少有方案被证明对咽部感染高度有效。在美国可用于治疗单纯性淋菌感染的抗菌药物中，头孢曲松（125毫克）、头孢克肟（400毫克）、环丙沙星（500毫克）和氧氟沙星（400毫克）似乎在已证实的疗效和安全性之间提供了最佳平衡。
