淋病
淋病奈瑟菌
阿奇霉素
医学
头孢曲松
抗生素耐药性
抗菌剂
头孢菌素
重症监护医学
内科学
微生物学
抗生素
家庭医学
生物
人类免疫缺陷病毒(HIV)
作者
Magnus Unemo,Daniel Golparian,David W Eyre
出处
期刊:Methods in molecular biology
日期:2019-01-01
卷期号:: 37-58
被引量:71
标识
DOI:10.1007/978-1-4939-9496-0_3
摘要
Gonorrhea and antimicrobial resistance (AMR) in Neisseria gonorrhoeae are major public health concerns globally. Dual antimicrobial therapy (mainly ceftriaxone 250–500 mg × 1 plus azithromycin 1–2 g × 1) is currently recommended in many countries. These dual therapies have high cure rates, have likely been involved in decreasing the level of cephalosporin resistance internationally, and inhibit the spread of AMR gonococcal strains. However, ceftriaxone-resistant strains are currently spreading internationally, predominately associated with travel to Asia. Furthermore, the first global treatment failure with recommended dual therapy was reported in 2016 and the first isolates with combined ceftriaxone resistance and high-level azithromycin resistance were reported in 2018 in the UK and Australia. New antimicrobials for treatment of gonorrhea are essential and, of the few antimicrobials in clinical development, zoliflodacin particularly appears promising. Holistic actions are imperative. These include an enhanced advocacy; prevention, early diagnosis, contact tracing, treatment, test-of-cure, and additional measures for effective management of anogenital and pharyngeal gonorrhea; antimicrobial stewardship; surveillance of infection, AMR and treatment failures; and intensified research, for example, regarding rapid molecular point-of-care detection of gonococci and AMR, novel AMR determinants, new antimicrobials, and an effective gonococcal vaccine, which is the only sustainable solution for management and control of gonorrhea.
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