Treatment of Gonorrhea

Apr 15, 2012 , Eva Papežová

lecba-kapavky.jpg - kopie
lecba-kapavky.jpg - kopie
Treatment of gonorrhea is usually performed in an outpatient department of dermatovenerology, only in serious cases hospitalization is needed (e.g. women with infected fallopian tubes and ovaries). Penicillin is no longer used in gonorrhea treatment, the right antibiotic is chosen according to culture test results. Any patient with gonorrhea must be registered and treated, including regular mandatory check-ups.

Treatment of Gonorrhea

Gonorrhea is one of the most common sexually transmitted diseases worldwide. It is caused by bacterium called Neisseria gonorrhoeae. Upon any suspicion of this disease, particularly in relation to risky sexual intercourse or in connection with partner's infidelity, medical expert called dermatovenerologist should be visited immediately. Gonorrhea is subject to mandatory reporting, which means the diagnosing doctor should communicate this information to the local health department. All patient's sexual contacts must be found, tested and treated if necessary. During gonorrhea treatment sexual abstinence is recommended. Gonorrhea treatment consists of antibiotics use. Underestimation of the symptoms of gonorrhea can complicate the situation and facilitate spread of the infection.

Symptoms of Gonorrhea

Symptoms of gonorrhea differ in men and women. Gonorrhea in women is symptomless in up to 75%, complications of untreated gonorrhea (infertility for example) are therefore more frequent than in men. If the infection manifests, it is usually by smelly vaginal discharge, painful urination, bleeding from the genital tract or nausea and vomiting. In men, gonorrhea usually manifests as inflammation of the urethra with painful urination, swelling and redness around the mouth of the urethra, sometimes purulent discharge from the urethra. Further spread of the infection can cause inflammation of the epididymis or prostate. As for women, untreated gonorrhea can cause infertility.

Treatment of Gonorrhea

Crucial for treatment of gonorrhea are well chosen antibiotics. Penicillin has been the drug of choice for years. Nowadays, with growing bacterial resistance to penicillin, the antibiotic is usually chosen according to culture test of the discharge from urethra or cervix that determines sensitivity of the bacteria to different types of antibiotics. In latter years, the most commonly administered antibiotic during gonorrhea treatment is ceftriaxone, third-generation cephalosporin antibiotic. It is administered into a muscle as so-called single megadose. Another possibility is doxycycline, a broad-spectrum antibiotic used orally 2 times a day for 7 to 10 days. This medicament is also used for concomitant treatment of gonorrhea and chlamydia. As a matter of fact, if the bacterium is resistant to all of these antibiotics, other antibiotics can be used, too. Hospitalization is usually not needed, only women with infection of the fallopian tubes or ovaries should be hospitalized to be treated by intravenous antibiotics. Regime measures should also be followed – sexual abstinence, limited physical activity, and alcohol abstinence. These measures should be followed until it is proven that the infection was perfectly treated.

Even pregnant woman can be infected by gonorrhea. Depending on the stage of pregnancy, it may cause miscarriage or premature birth. At delivery, the child is at risk of infection during passage through the birth canal of the infected mother. In newborns, the disease manifests by a purulent discharge from the eyes or swelling of the eyelids, sometimes the infection of the eyes can result in blindness. To prevent this, all children of infected women are administered disinfecting drops to prevent further spread of infection.

Follow-up after Treatment of Gonorrhea

Because gonorrhea is a sexually transmitted disease, it is necessary to treat the patient and his/her sexual partner or partners simultaneously. Treatment success is checked by several bacteriological tests that are mandatory. The first is performed within 48 hours after the treatment has started. The other are performed in a weekly interval for about 4 months, together with preventive blood testing for HIV and syphilis. If all the tests prove negative, the patient is removed from the register. The treatment of gonorrhea is simple and effective in preventing later complications if started early.

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