米国CDC：淋病治療第1選択としてセフィキシム禁止 CTRX注＋AZT or DOXY

CDCガイドライン：淋菌感染

・　淋病への第1選択としてのcefixime使用ルーチン処方の禁止
・　dual therapy：　ceftriaxone （ロセフィンなど）注射　＋経口（azithromycin or doxycylineのいずれか）
・　ceftriaxone使用不能なら、cefiximeを使用すべき
・　注射後1週間後治癒確認再診を義務づけ

---

BOX. Updated recommended treatment regimens for gonococcal infections

Uncomplicated gonococcal infections of the cervix, urethra, and rectum Recommended regimen Ceftriaxone 250 mg in a single intramuscular dose PLUS Azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7 days* Alternative regimens If ceftriaxone is not available: Cefixime 400 mg in a single oral dose PLUS Azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7 days* PLUS Test-of-cure in 1 week If the patient has severe cephalosporin allergy: Azithromycin 2 g in a single oral dose PLUS Test-of-cure in 1 week Uncomplicated gonococcal infections of the pharynx Recommended regimen Ceftriaxone 250 mg in a single intramuscular dose PLUS Azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7 days* * Because of the high prevalence of tetracycline resistance among Gonococcal Isolate Surveillance Project isolates, particularly those with elevated minimum inhibitory concentrations to cefixime, the use of azithromycin as the second antimicrobial is preferred.

Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral Cephalosporins No Longer a Recommended Treatment for Gonococcal Infections
WeeklyAugust 10, 2012 / 61(31);590-594
 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm?s_cid=mm6131a3_w


CDC：gonorrhea関連
http://www.cdc.gov/std/Gonorrhea/


 淋病は不妊に大きく影響し、HIV感染などもからみ問題となっている。抗生剤耐性が深刻で、 cefixime susceptibility感受性低下が話題となっていた。