缺乏大剂量头孢曲松单药治疗生殖器外淋病奈瑟菌(NG)感染的有效性的证据。
每3个月对一群男男性行为者(MSM)进行NG/沙眼衣原体(CT)检测,在东京的单中心观测研究中,日本。包括年龄>19岁的MSM,在2017年至2020年之间诊断为生殖器外NG感染。提供了1克头孢曲松单药治疗,同时给予单一剂量口服1g阿奇霉素或100mg多西环素的双重治疗,每天两次口服,持续7天,对于那些同时感染了CT的人来说,根据受感染的地点。这些治疗的功效通过治愈测试时NG阴性受试者的数量除以治疗的受试者的数量来计算。采用Fisher精确检验比较两组疗效。
320例诊断为外型NG,208例接受单一疗法治疗,112例接受双重疗法治疗。对总的功效,咽部,直肠感染为98.1%(204/208,95%置信区间[CI]:95.2-99.3%),97.8%(135/138,95%CI:93.8-99.4%),和98.6%(69/70,95%CI:92.3-99.9%),分别,在单药治疗组中,而双重治疗的相应疗效为95.5%(107/112,95%CI:90.0-98.1%),96.1%(49/51,95%CI:86.8-99.3%),和95.1%(58/61,95%CI:86.5-98.7%),分别。两组之间的相应疗效没有显着差异(分别为P=0.29,P=0.61,P=0.34)。
在MSM中,大剂量头孢曲松单药治疗与生源外NG的双重治疗一样有效。
Evidence on efficacy of high-dose ceftriaxone monotherapy for extragenital Neisseria gonorrhoeae (NG) infection is lacking.
A cohort of men who have sex with men (MSM) were tested for NG/Chlamydia trachomatis (CT) every 3 months, in a single-center observational study in Tokyo, Japan. MSM aged > 19 years diagnosed with extragenital NG infection between 2017 and 2020 were included. A single dose of 1 g ceftriaxone monotherapy was provided, while dual therapy with a single oral dose of 1 g azithromycin or 100 mg doxycycline administered orally twice daily for 7 days were given, for those coinfected with CT, according to infected sites. Efficacy of these treatments was calculated by the number of NG-negative subjects at test-of-cure divided by the number of subjects treated. Fisher exact tests were used to compare the efficacy between the 2 groups.
Of 320 cases diagnosed with extragenital NG, 208 were treated with monotherapy and 112 were treated with dual therapy. The efficacy against total, pharyngeal, and rectal infections was 98.1% (204/208, 95% confidence interval [CI]: 95.2-99.3%), 97.8% (135/138, 95% CI: 93.8-99.4%), and 98.6% (69/70, 95% CI: 92.3-99.9%), respectively, in the monotherapy group, whereas the corresponding efficacy in the dual therapy was 95.5% (107/112, 95% CI: 90.0-98.1%), 96.1% (49/51, 95% CI: 86.8-99.3%), and 95.1% (58/61, 95% CI: 86.5-98.7%), respectively. No significant difference in the corresponding efficacy was observed between the two groups (P = .29, P = .61, P = .34, respectively).
High-dose ceftriaxone monotherapy is as effective as dual therapy for extragenital NG among MSM.