39192
document
A comparison of single-dose cefixime with ceftriaxone as treatment for uncomplicated gonorrhea . The Gonorrhea Treatment Study Group . BACKGROUND Because of the widespread existence of Neisseria gonorrhoeae resistant to penicillin or tetracycline , ceftriaxone is now recommended for the treatment of gonorrhea . There is , however , a need for effective antibiotics that can be administered orally as an alternative to ceftriaxone , which requires intramuscular administration . Cefixime is an orally absorbed cephalosporin that is active against resistant gonococci and has pharmacokinetic activity suitable for single-dose administration . METHODS AND RESULTS In a randomized , unblinded multicenter study of 209 men and 124 women with uncomplicated gonorrhea , we compared three single-dose treatment regimens : 400 mg or 800 mg of cefixime , administered orally , and 250 mg of ceftriaxone administered intramuscularly . The overall cure rates were 96 percent for the 400-mg dose of cefixime ( 89 of 93 patients ) ( 95 percent confidence interval , 93.5 percent to 97.8 percent ) ; 98 percent for the 800-mg dose of cefixime ( 86 of 88 patients ) ( 95 percent confidence interval , 94.6 percent to 100 percent ) ; and 98 percent for ceftriaxone ( 92 of 94 patients ) ( 95 percent confidence interval , 94.9 to 100 percent ) . The cure rates were similar in men and women , and pharyngeal infection was eradicated in 20 of 22 patients ( 91 percent ) . Thirty-nine percent of 303 pretreatment gonococcal isolates had one or more types of antimicrobial resistance ; the efficacy of all three regimens was independent of the resistance pattern . Chlamydia trachomatis infection persisted in at least half the patients infected in each treatment group . All three regimens were well tolerated . CONCLUSIONS In the treatment of uncomplicated gonorrhea , a single dose of cefixime ( 400 or 800 mg ) given orally appears to be as effective as the currently recommended regimen of ceftriaxone ( 250 mg given intramuscularly ) .
39193
Intervention_Pharmacological
cefixime
39194
Intervention_Pharmacological
ceftriaxone
39195
Intervention_Pharmacological
ceftriaxone
39196
Intervention_Pharmacological
400 mg or 800 mg of cefixime
39197
Intervention_Pharmacological
administered orally
39198
Intervention_Pharmacological
250 mg of ceftriaxone
39199
Intervention_Pharmacological
cefixime
39200
Intervention_Pharmacological
cefixime
39201
Intervention_Pharmacological
ceftriaxone
39202
Intervention_Pharmacological
cefixime
39203
Intervention_Pharmacological
ceftriaxone
39204
Outcome_Physical
uncomplicated gonorrhea
39205
Outcome_Physical
gonorrhea
39206
Outcome_Other
overall cure rates
39207
Outcome_Other
cure rates
39208
Outcome_Physical
pharyngeal infection
39209
Outcome_Other
efficacy
39210
Outcome_Physical
Chlamydia trachomatis infection
39211
Outcome_Other
tolerated
39212
Outcome_Physical
uncomplicated gonorrhea
39213
Outcome_Other
effective
39214
Participant_Condition
gonorrhea
39215
Participant_Sample-size
209
39216
Participant_Sample-size
124
39217
Participant_Condition
gonorrhea