Bogaerts J, Tello W M, Akingeneye J, Mukantabana V, Van Dyck E, Piot P
Centre Hospitalier De Kigali.
Genitourin Med. 1993 Jun;69(3):196-200. doi: 10.1136/sti.69.3.196.
To study the effectiveness of single-dose norfloxacin and ofloxacin in the treatment of gonococcal urethritis in men, and to monitor in vitro antimicrobial susceptibility to these antibiotics over time.
Centre Médico-Social de Bilyogo, Kigali, Rwanda. The only clinic in Rwanda using quinolones for the treatment of gonorrhoea.
As part of a monitoring programme, men with gonococcal urethritis were evaluated after treatment with norfloxacin (800 mg) in 1986 and 1987, and after treatment with ofloxacin (400 mg) in 1989.
Neisseria gonorrhoeae was eradicated from the urethra from 96.0% (189/197) and from 97.1% (166/171) men treated with norfloxacin and ofloxacin, respectively. Overall 38.2% of the pretreatment isolates produced penicillinase (PPNG isolates) and 20.4% (44/216) of the tested non-PPNG isolates were chromosomally resistant to penicillin (MIC > or = 2.0 mg/l). Resistance to tetracycline and thiamphenicol was common in both PPNG and non-PPNG and increased considerably in 1989. All isolates were susceptible to kanamycin, spectinomycin, ceftiaxone, norfloxacin, ofloxacin and ciprofloxacin. However, a higher number of isolates recovered in 1989 showed decreased susceptibility to the quinolones. Treatment failure occurred more often in subjects with isolates having MIC values > or = 0.06 mg/L of norfloxacin (p = 0.006). Seven out of 13 patients who did not respond to therapy had no signs nor symptoms of urethritis.
Quinolone antibiotics are now indicated as a first line treatment of gonorrhoea in countries with a problem of antimicrobial multiresistance. However, antimicrobial susceptibility to the quinolones may decrease rapidly, and close monitoring of the in vitro susceptibility of N gonorrhoeae and the clinical effectiveness of the antibiotics is imperative.
研究单剂量诺氟沙星和氧氟沙星治疗男性淋菌性尿道炎的疗效，并长期监测这些抗生素的体外抗菌敏感性。
卢旺达基加利的比利奥戈医疗社会中心。卢旺达唯一一家使用喹诺酮类药物治疗淋病的诊所。
作为一项监测计划的一部分，1986年和1987年对接受诺氟沙星（800毫克）治疗的男性淋菌性尿道炎患者进行了评估，1989年对接受氧氟沙星（400毫克）治疗的患者进行了评估。
接受诺氟沙星和氧氟沙星治疗的男性患者中，分别有96.0%（189/197）和97.1%（166/171）的尿道淋病奈瑟菌被清除。总体而言，38.2%的治疗前分离株产生青霉素酶（PPNG分离株），20.4%（44/216）的非PPNG测试分离株对青霉素具有染色体抗性（MIC≥2.0毫克/升）。PPNG和非PPNG分离株对四环素和甲砜霉素的耐药性都很常见，并且在1989年显著增加。所有分离株对卡那霉素、壮观霉素、头孢曲松、诺氟沙星、氧氟沙星和环丙沙星均敏感。然而，1989年分离出的更多分离株对喹诺酮类药物的敏感性降低。在诺氟沙星MIC值≥0.06毫克/升的分离株患者中，治疗失败更为常见（p = 0.006）。13例治疗无反应的患者中有7例没有尿道炎的体征和症状。
在存在多重抗菌耐药问题的国家，喹诺酮类抗生素现在被指定为淋病的一线治疗药物。然而，对喹诺酮类药物的抗菌敏感性可能会迅速下降，因此必须密切监测淋病奈瑟菌的体外敏感性和抗生素的临床疗效。
