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Treatment of gonorrhea
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Does gonorrhea go away on its own?
Gonorrhea does not go away on its own. This is explained by the fact that the cells of the immune system cannot capture and destroy absolutely all gonococci that have entered the body, as a result of which the latter continue to actively multiply. Over time, the reactivity of the body's immune system to the infectious agent decreases. The gonococcal flora continues to remain in the mucous membranes of the genitourinary organs, but the immune system reacts to it less and less intensely. As a result, the disease becomes torpid, chronic or latent, which is fraught with the development of serious complications.Which doctor treats gonorrhea?
The diagnosis and treatment of gonorrhea is carried out by a dermatovenerologist. It is he who should be contacted when the first signs of the disease appear ( pain or itching in the urethra, purulent discharge from it, and so on). At the first visit, the doctor carefully examines the patient and collects a detailed medical history, after which he prescribes additional laboratory tests.To clarify the diagnosis, the doctor may ask the patient:
- When did the first symptoms of the disease appear?
- How many sexual partners did the patient have during the last 2 weeks?
- When was the patient's last sexual intercourse?
- Has the patient or their sexual partner had similar symptoms in the past?
After making a diagnosis, the dermatovenerologist prescribes the necessary treatment, which in most cases is carried out at home. Hospitalization may be required if infectious complications develop, which usually occur in elderly or debilitated patients. Also, the doctor may insist on hospitalization if he doubts the possibility of adequate treatment at home ( for example, when the family of a sick child is in an unfavorable state, when the patient lives in unsanitary conditions, and so on).
Antibiotics for gonorrhea
Taking antibiotics is the main treatment measure for all forms of gonorrhea. In a fresh acute form of the disease, a full course of antibiotic therapy may be sufficient to completely cure the patient, while in a torpid or chronic form other therapeutic measures may be required.Treatment of gonorrhea with antibiotics
Group of drugs | Representatives | Mechanism of therapeutic action | Directions for use and doses |
Penicillins | Benzylpenicillin | This drug has been successfully used for many years to treat acute forms of gonorrhea. The mechanism of the therapeutic effect of penicillin antibiotics is that they suppress the process of synthesis of the cell wall of gonococci, as a result of which the latter die. | The drug is administered intramuscularly. The initial dose is 600 thousand Action Units ( ED), after which 300 thousand units are administered every 3–4 hours. Course dose for fresh acute and subacute ( uncomplicated) gonorrhea is 3.4 million units. In case of chronic gonorrhea, as well as with the development of complications from other organs and systems, the course dose can be increased to 4.2 - 6.8 million units. For eye damage, benzylpenicillin can be used in the form of eye drops ( 20 – 100 thousand units in 1 milliliter of saline solution). They should be used 6 - 8 times a day, instilling 1 - 2 drops into each eye. |
Bicillin-3 | A long-acting drug containing three salts of benzylpenicillin. | For acute and subacute gonorrhea, the drug is administered deeply intramuscularly at a dose of 2.4 million units ( 1.2 million units in the outer upper quadrant of each buttock). |
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Augmentin | Due to the widespread and often incorrect use of antibiotics, some varieties of gonococci have learned to produce a special substance ( B-lactamase), which destroys penicillins, thereby eliminating their destructive effect on the pathogen itself. Augmentin is a combination drug that contains the penicillin antibiotic amoxicillin and clavulanic acid, which protects it from the action of B-lactamases. | Adults are prescribed 500–1000 mg orally 3 times a day. Children – 250 – 500 mg three times a day. |
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Macrolides | Clarithromycin | They are used for the ineffectiveness of penicillins, as well as for mixed gonorrheal-chlamydial infection. They damage components of the genetic apparatus of gonococci, thereby disrupting the process of synthesis of intracellular proteins and making further reproduction of bacteria impossible. | For adults and children over 12 years of age, the drug is prescribed orally at 250–500 mg every 12 hours. The course of treatment is 6 – 12 days. |
Erythromycin | The drug is prescribed orally, in the first 3 days of treatment - 500 mg every 6 hours, and over the next 7 days - 250 mg every 6 hours. |
Immunotherapy for gonorrhea
Specific immunotherapy consists of administering to the patient a special gonovaccine containing inactive forms of gonococci, which stimulate the immune system and increase the body's resistance. The drug is administered intramuscularly ( the initial dose usually contains 300 – 400 million microbial bodies). After 1–2 days, the drug is re-administered, with good tolerability and no side effects ( usually of an allergic nature) the dose is increased by 150 - 300 million microbial bodies with each repeated injection ( but not more than 2 billion for 1 administration). The full course of treatment includes 6 – 8 injections.Local treatment of gonorrhea
Locally for gonorrhea, drugs that are bactericidal ( killing bacteria) and antiseptic ( disinfectant) action. This allows you to slow down the progression of the disease, as well as prevent the spread of infection through contact and household contact, as it helps to destroy gonococci.Local treatment for gonorrhea includes:
- Rinsing the urethra with a solution of potassium permanganate at a dilution of 1:10,000.
- Rinsing the urethra with a solution of chlorhexidine at a dilution of 1:5000.
- Rinsing the urethra with a 0.25% solution of silver nitrate or a 2% solution of protargol.
- The use of warm ( 35 – 38 degrees) baths with potassium permanganate ( 1:10000 ) or furatsilin ( 1:5000 ) with damage to the skin.
Suppositories for gonorrhea
Rectal suppositories can be prescribed to improve the patient’s general condition and eliminate systemic manifestations of the infectious and inflammatory process. It is also worth noting that the rectal route of administration ( through the anus into the rectum) is preferable to taking tablets orally. This is explained by the fact that the drunk tablet is absorbed in the stomach and enters the so-called portal vein, through which blood flows to the liver. When passing through the liver, part of the medication is inactivated, which significantly reduces its effectiveness and requires taking large doses of drugs. Also, certain medications can have a toxic effect on liver cells. When drugs are administered rectally, they are absorbed in the lower parts of the rectum and enter directly into the systemic bloodstream, bypassing the portal vein and liver, thereby reducing the severity of the described side effects.Rectal suppositories for gonorrhea
Group of drugs | Representatives | Mechanism of therapeutic action | Dosage |
Nonsteroidal anti-inflammatory drugs (NSAIDs) | Paracetamol | Drugs from this group block the development of the inflammatory process in the body, providing antipyretic and analgesic effects. | Adults are administered 1 suppository ( 500 mg) 2 – 4 times a day, for children the dose is calculated depending on age. |
Indomethacin | Adults are administered 1 suppository ( 50 mg) 1 – 3 times a day. |
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Antispasmodics | Papaverine | This drug relaxes spasmodic ( overly shortened) smooth muscles of internal organs, which helps eliminate pain in various complications of gonorrhea. | Adults are administered 20–40 mg 2–3 times a day. |
Immunomodulators | Viferon (interferon a2b) | This drug has a pronounced immunostimulating effect ( increases nonspecific activity of the immune system), and also slows down the process of proliferation of connective tissue in the urethra and other affected organs ( which is often observed when gonorrhea becomes chronic). | The drug is administered to adults at a dose of 500,000 IU ( International Units) 2 times a day ( every 12 hours) within 5 – 10 days. |
Treatment of chronic gonorrhea
Treatment of chronic gonorrhea is usually long-term and requires the use of the entire arsenal of therapeutic measures that are also used in the acute form of the disease.Treatment for chronic gonorrhea includes:
- Antibiotics– are used for a long time, for several weeks.
- Immunomodulators ( gonovaccine, pyrogenal) – are prescribed to stimulate the body’s general defenses.
- Anti-inflammatory drugs– are prescribed only during the period of exacerbation of the disease.
- Physiotherapy ( magnetic therapy, laser therapy) – allow not only to reduce the severity of proliferative processes in the urethra, but also to accelerate the process of wound healing and restoration of damaged tissue after exacerbations of the disease.
- Treatment of developing complications from various organs and systems.
Treatment of extragenital gonorrhea
Treatment of extragenital forms of gonorrhea ( gonorrhea of the rectum, skin lesions, conjunctiva of the eye and so on) is similar to that in classical forms of the disease, but includes a number of features.Extragenital forms of gonorrhea include:
- Anal gonorrhea ( rectal gonorrhea). The basis of treatment measures is also the administration of benzylpenicillin, the course dose of which is 6 million units. Among other antibacterial drugs, preference is given to chloramphenicol ( orally 250 – 50 mg 2 – 4 times a day for 3 days) or ciprofloxacin ( orally 250 mg 2 – 3 times a day for 7 – 10 days). It is also recommended to use rectal suppositories with protargol ( 20 mg 1 time per day). Protargol ( silver preparation) forms a thin protective film on the surface of the damaged or ulcerated mucous membrane, which has an antiseptic, anti-inflammatory and antimicrobial effect.
- Oropharyngeal gonorrhea. If the mucous membrane of the throat or oral cavity is affected, systemic antibacterial drugs are prescribed ( eg ciprofloxacin, azithromycin). It is also recommended regularly ( several times a day) gargle with a weak saline or soda solution ( 1 teaspoon of salt/soda per glass of warm boiled water), which will also have an antibacterial effect.
- Gonorrhea of the eyes. In this case, the systemic use of antibacterial drugs is combined with antibacterial ( benzylpenicillin) and anti-inflammatory eye drops. The drug protargol can also be used in the form of eye drops ( 2 – 3 drops of 1% solution in each eye 2 – 3 times a day).
Treatment of gonorrhea during pregnancy
Treatment of gonorrhea during pregnancy can present certain difficulties due to the toxic effects of some antibacterial drugs on the developing fetus. However, if gonorrhea is detected in a pregnant woman, treatment is still prescribed, since possible infection of the fetus during childbirth can lead to much more serious and irreparable consequences.Treatment of gonorrhea in pregnant women is carried out only in a hospital setting, where the doctor can regularly monitor the condition of the mother and fetus, as well as promptly identify and eliminate possible side effects.
Treatment for gonorrhea in pregnant women may include:
- Antibacterial drugs ( benzylpenicillin, erythromycin, chloramphenicol). In the first trimester of pregnancy, it is recommended to begin treatment with minimal therapeutic doses, since it is at this time that all organs and tissues of the embryo are formed, and the effects of antibiotics can negatively affect this process. Starting from the second trimester of pregnancy, the dose of drugs can be increased by one and a half to two times, since the severity of their toxic effect on the fetus is significantly reduced.
- Gonovaccine. This drug can be prescribed from the third trimester of pregnancy to 150 - 200 million microbial bodies ( the method of administration has been described previously).
- Local treatment. If a woman is diagnosed with gonorrhea, local treatment should be carried out at any stage of pregnancy, right up to childbirth. In this case, preference is given to vaginal baths ( for this you can use a solution of potassium permanganate at a concentration of 1:10000 or a 2% solution of protargol). Administration of any drugs ( for example, candles) in the vagina during pregnancy is strictly prohibited.
Treatment of gonorrhea with folk remedies at home
Traditional recipes are successfully used to treat gonorrhea. However, it is worth remembering that the cause of the development of this disease is a bacterial infection, which is quite difficult to eradicate without antibacterial drugs. That is why traditional treatment is recommended to be combined with drug therapy prescribed by a dermatovenerologist.To treat gonorrhea at home you can use:
- Infusion of chamomile flowers. The substances contained in chamomile flowers have anti-inflammatory and some antimicrobial effects, which are used to eliminate the symptoms of gonorrhea. To prepare the infusion 20 grams ( about 4 full tablespoons) crushed chamomile flowers should be poured into 500 ml of warm boiled water and placed in a water bath for 10 - 15 minutes. After this, cool, strain and use externally. The infusion can be used in the form of baths ( for lesions of the urethra in men or women), for mouth rinsing ( 3 – 4 times a day) or for microenemas for anal gonorrhea ( in this case, 50 milliliters of warm infusion are injected into the rectum 2 - 3 times a day).
- Infusion of yarrow herb. The tannins and essential oils contained in this plant provide anti-inflammatory, antimicrobial and wound-healing effects, which are successfully used in the treatment of acute and subacute gonorrhea. To prepare the infusion, add 4 tablespoons of crushed yarrow herb to 500 milliliters of warm boiled water and keep in a water bath for 15 minutes. Cool at room temperature for 1 – 2 hours and take 2 tablespoons orally three times a day ( half an hour before meals).
- Infusion of St. John's wort herb. This plant also has anti-inflammatory, astringent and wound-healing effects, which is successfully used to treat gonorrhea of the throat and oral cavity. To prepare the infusion, 50 grams of crushed St. John's wort herb should be poured with 500 milliliters of boiling water and kept in a water bath for half an hour. Then the infusion should be cooled, strained and used to rinse the mouth and throat three times a day ( 2 hours before or one hour after meals).
Criteria for cure of gonorrhea
To remove a patient from registration, it is necessary to ensure that gonococci are completely removed from his body. After suffering acute gonorrhea, a man can be considered healthy after a single examination ( 7 – 10 days after the end of antibiotic therapy). Women need to be examined three times - the first time - 7 days after finishing the course of antibiotics, the second time during the next menstruation and the third time immediately after its end.The criteria for curing gonorrhea are:
- Absence of any subjective manifestations of the disease ( soreness, itching or burning in the urethra, difficulty urinating, and so on).
- The absence of gonococci in a three-fold bacterioscopic examination of smears from the patient’s mucous membranes ( after a combined provocation using gonovaccine, pyrogenal and other methods).
- A single negative bacteriological study, also carried out after a combined provocation ( For culture, smears from the mucous membrane of the urethra, cervical canal, vagina, rectum, and so on can be used.).
Gonorrhea prevention
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Prevention of gonorrhea includes:
- Change in sexual behavior. People who frequently change sexual partners and are promiscuous are at greatest risk of contracting gonorrhea. It is important to remember that a person can be contagious even if he does not have obvious clinical manifestations of gonorrhea ( quite often people themselves do not know that they are sick). That is why one of the main preventive measures for gonorrhea is the exclusion of unprotected sexual contact with an unknown partner.
- Timely detection of gonorrhea in a sexual partner. When acute gonorrhea develops in a man, the diagnosis is usually made within 1–2 days, due to the severity of the clinical manifestations of the disease. At the same time, in women this pathology can be asymptomatic for a long time. That is why, when starting to live together, partners are recommended to undergo a series of simple examinations in order to identify hidden forms STI ( sexually transmitted infections) , which includes gonorrhea.
- Complete treatment of gonorrhea in a sexual partner. It is important to continue treatment for the entire period prescribed by the doctor, even if there are no clinical manifestations of the disease. If you stop taking antibacterial drugs too early, some gonococci may survive, which may cause a relapse ( re-exacerbation) or the development of a latent form of the disease.
- Avoiding unprotected sex up to the removal of the infected sexual partner from the dispensary register with a dermatovenerologist.
- Preventive examination of people at risk. The group at increased risk of developing gonorrhea includes teenagers and people aged 18 to 30 years who are promiscuous, as well as homosexuals. Also at risk are married couples who fail to conceive a child within 1 year of regular sexual activity ( in this case, the cause of infertility may be various complications of gonorrhea occurring in a latent form).
Hygiene for gonorrhea
Compliance with personal hygiene rules becomes especially important if a sexual partner or any family member is diagnosed with gonorrhea. It is important to note that these rules must be followed by the sick person himself, as well as all the people around him.Hygiene measures for gonorrhea include:
- Regular ( at least once a day) taking a shower, during which you should use disinfectant soap.
- Use of individual personal hygiene items ( washcloths, towels, toothbrushes and so on) by each family member. The use of personal hygiene items by a person with gonorrhea is unacceptable.
- Regular ( daily) change of bed linen during the entire period of treatment of acute gonorrhea.
Is it possible to have sex while treating gonorrhea?
Gonorrhea is a sexually transmitted infectious disease ( this route of infection is observed in more than 95% of all cases of gonorrhea). Considering this fact, it becomes clear that if acute gonorrhea is detected in a sexual partner, it is recommended to abstain from sexual intercourse until he is completely recovered, since otherwise this can lead to the development of a number of complications.Having sex while being treated for gonorrhea can cause:
- Infection of a sexual partner. In the presence of pronounced clinical manifestations of gonorrhea, even mechanical methods of protection cannot completely eliminate the risk of infection ( that is, condoms). At the same time, after the start of treatment, the symptoms of the disease usually subside quite quickly, and therefore the couple decides to resume sexual activity. This is a rather serious mistake, since a patient with acute gonorrhea is infectious throughout the entire period of treatment, even while taking antibacterial drugs.
- Exacerbations of the disease. During sexual intercourse, irritation and injury to the mucous membrane of the genitourinary tract occurs, which can contribute to the spread of infection.
- Relapse. If you continue to have sex with an infected partner during treatment ( who is not taking treatment), there is a high probability of re-infection, as a result of which, after discontinuation of antibacterial drugs, the clinical picture of the disease may develop again.
- Development of complications. Having sex during acute gonorrhea can cause pain in the urethra, and trauma to the inflamed mucous membrane can cause bleeding.
Prevention of gonorrhea in newborns
The most effective method of preventing gonorrhea in a newborn is the prevention and treatment of this pathology in the mother during pregnancy planning. However, if a pregnant woman still suffers from gonorrhea, and it is not possible to cure this disease before the baby is born, there is a high probability that the baby will become infected with gonococci during passage through the birth canal. Since most often this leads to damage to the child’s eyes ( that is, to the development of conjunctivitis), children born from mothers with gonorrhea are instilled into each conjunctival sac with 2 drops of sodium sulfacyl ( antibacterial drug that destroys gonococci). This procedure should be performed immediately after the birth of the baby, and then again after 2 hours. If a girl is born, the genitals should also be treated with sodium sulfacyl solution.Consequences and complications of gonorrhea
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Gonorrhea in men can be complicated by:
- Littreit ( inflammation of the Littre glands). These glands are located in the submucosal layer of the urethra along its entire length ( from the external opening of the urethra to the wall of the bladder) and produce mucus. When they are inflamed, redness of the mouths of the glands and their gaping may be observed, which is determined during examination by a doctor. Also, with this complication, the amount of mucous discharge from the urethra may increase.
- Inflammation of Morgagni lacunae. These gaps ( recesses) are located on the inner surface of the urethral mucosa and are also quite often inflamed with gonorrhea.
- Colliculitis ( inflammation of the seminal tubercle). The seminal tubercle is a muscular formation that is located in the posterior wall of the urethra and through which the vas deferens pass. When it is inflamed, patients complain of pain in the penis, upper thigh or lower abdomen. There may also be a problem with ejaculation ( ejaculation).
- Tizonite ( inflammation of the tizon glands). These are sebaceous glands that are located in the skin of the foreskin of the penis. When inflamed, they increase in size ( up to 5 – 7 millimeters), become dense and sharply painful when palpated, and when pressing on them, pus may be discharged. The skin over the inflamed glands is red ( hyperemic), edematous.
- Lymphangitis ( inflammation of the lymphatic vessels). This complication develops during the aggressive course of gonorrhea, when a large number of pathogens penetrate the lymphatic system. A dense and sharply painful lymphatic vessel is usually located on the upper surface of the penis, the skin over it may be swollen and hyperemic.
- Inguinal lymphadenitis ( inflammation of the inguinal lymph nodes). This is a common complication of gonorrhea, which, however, rarely leads to purulent melting of the lymph nodes ( Usually, inflammation in the lymph nodes disappears after starting antibiotic treatment).
- Acute prostatitis ( inflammation of the prostate gland). Occurs when gonococci penetrate the prostate. It is characterized by pain in the perineum, frequent urge to urinate, disruption of the process of urine excretion, increased body temperature to 38 - 39 degrees, and so on. On palpation ( palpation) the prostate is enlarged, hardened and sharply painful.
- Vesiculitis ( inflammation of the seminal vesicles). It manifests itself as acute pain in the pelvic area, intensifying during sexual arousal. Hematuria may also be present ( the appearance of blood in the urine).
- Epididymitis ( inflammation of the epididymis). This complication is manifested by sharp stabbing pain in the testicular area, swelling and hyperemia of the scrotum. Body temperature can rise to 40 degrees. Even without treatment, the inflammatory process subsides after 4–5 days, however, a connective tissue scar may form in the area of the appendage, blocking the lumen of the appendage and disrupting the process of sperm release, which can cause male infertility.
- Endometritis ( inflammation of the uterine mucosa). This complication develops when gonococci spread from lower parts of the genitourinary system ( from the vagina or cervix). Endometritis manifests itself as acute cramping pain in the lower abdomen, an increase in body temperature up to 39 degrees, and menstrual irregularities ( mucous-bloody or purulent discharge may occur outside of menstruation). The uterus itself is enlarged and painful on palpation.
- Salpingitis ( inflammation of the fallopian tubes). The fallopian tubes are the channels through which a fertilized egg enters the uterine cavity during conception. With salpingitis, patients complain of sharp stabbing pain in the lower abdomen, which intensifies during movement, urination or defecation. At the same time, the body temperature rises to 38 - 39 degrees, the woman’s general condition worsens. The most dangerous outcome of salpingitis is the proliferation of connective tissue and the formation of adhesions, which block the lumens of the fallopian tubes, leading to the development of infertility.
- Pelvioperitonitis. This term refers to inflammation of the pelvic peritoneum - a thin serous membrane lining the organs and walls of the pelvis. Infection in the peritoneum can spread from the lumen of the fallopian tubes during salpingitis. The development of pelvioperitonitis is characterized by a deterioration in the general condition of the woman, the appearance of widespread pain in the lower abdomen, an increase in body temperature to 39 - 40 degrees, constipation ( due to impaired intestinal motor function). The abdominal wall is tense and painful on palpation.
The treatment regimen in each case is selected by the doctor individually, only after the patient has been examined and examined. This is necessary in order to confirm the presence of gonococcus and choose the optimal therapy.
That, which exactly take antibiotics or prick for gonorrhea will depend:
- Depending on the form of the disease: whether it is acute or chronic, whether it was detected for the first time or whether the infection occurred repeatedly.
- The presence or absence of concomitant genital infections, such as candidiasis, trichomoniasis or chlamydia.
- Results that determine the susceptibility of bacteria to a certain type of antibiotic.
On average, treatment for uncomplicated gonorrhea can last from 5 to 15 days.
Antibiotics at complicated gonorrhea can be prescribed by a doctor for up to 20 days. The usual treatment regimen involves injections given every other day. There are also accelerated treatment regimens, lasting from 3 to 5 days. With this treatment, several antibiotics are used at once, and injections are given every day.
Recovery with this shock method of therapy occurs faster. However, it is used only as a last resort, as it puts too much stress on the patient’s body.
When treating with antibiotics, it is important to strictly follow the order of administration and dosage. That's why antibiotics for gonorrhea in tablets are prescribed less frequently and, as a rule, as complementary agents. Mostly drugs are used in the form of injections. The fact is that for injections the patient needs to go to the hospital. This means that he is more likely not to miss the next dose of the drug. In addition, injectable forms have greater bioavailability and a high speed of action. This means that the symptoms of the disease will disappear faster than with treatment with pills.
Antibiotics in the treatment of gonorrhea therapy in men and women
In men, gonorrhea can be complicated by inflammatory phimosis or balanoposthitis.
A rare complication is tizonitis - an abscess of the glands of the foreskin.
Sometimes gonococcal lesions of the prostate and testicles may develop. In this case, immunomodulators are additionally prescribed.
Also, in addition to antibiotics for gonorrhea in men, the urogenital canal is washed with antiseptics. For example, such as Chlorhexidine or Protargol.
Therapy antibiotics for gonorrhea in women has its own characteristics only during pregnancy. In this case, treatment, regardless of the duration, will be carried out in a hospital. The drugs of choice are macrolides. Mainly Spectinomycin, or cephalosporins such as Ceftriaxone or Cefotaxime.
Immunomodulators during pregnancy are used only in rare cases with a complicated course of the disease.
Antibiotic treatment of chronic gonorrhea
In chronic forms of infection, antibiotics will also be the mainstay of therapy. But the schemes for their use, as well as the duration of treatment, are completely different.
Besides antibiotics for complicated gonorrhea, the treatment regimen includes immunomodulator drugs:
- Inactivated gonococcal vaccine - contains a killed gonococcus culture, which, when released into the blood, causes activation of the immune system. More precisely, it stimulates the production of gonorrhea-specific antibodies.
- Pyrogenal is a drug that contains lipopolysaccharide obtained from the bacterium Salmonella typhi. It works in the same way as the gonovaccine. True, stimulating nonspecific, that is, not aimed specifically at gonococcus, immunity.
Antibiotic treatment of extragenital gonorrhea
Usually, once they enter the bloodstream, gonococci quickly die due to the protection of the immune system. However, in some cases, the pathogen can penetrate through the bloodstream into other tissues and organs. In this case, a form of the disease develops, which doctors call extragenital gonorrhea.
It usually comes in three forms:
- Anal gonorrhea, which affects the rectal mucosa. In this case, doctors may additionally prescribe suppositories with protargol. The colloidal silver they contain creates a protective film on the mucous membrane, which has an anti-inflammatory and healing effect.
- Oropharyngeal gonorrhea, in which gonococcus settles in the oral cavity and on the mucous membrane of the throat. In this case, in addition to antibiotics, the treatment regimen includes antiseptic drugs in the form of aerosols or rinsing solutions.
- Gonorrheal eye damage, in which the standard regimen of antibiotics is supplemented with antibacterial drugs in the form of eye drops or ointments.
What antibiotic to take for gonorrhea, the doctor must decide!
Self-treatment with an incorrectly selected drug can lead to complications or the infection becoming chronic. The effectiveness of treatment is assessed not only by the absence of symptoms of the disease, but also by negative test results for gonococcus. A repeat examination is carried out after completing the course of antibiotics and again after three months.
If you suspect gonorrhea, contact a competent venereologist.
Gonorrhea is an infectious pathology caused by gram-negative diplococci (gonococci) and accompanied by damage to the mucous membrane lining the genitourinary tract (in rare cases, the mucous membranes of the conjunctiva, oropharynx, tonsils, and rectum are affected). It is transmitted primarily through sexual contact, although you can also become infected at home: through hygiene items, shared showers, etc. Newborns become infected during childbirth by passing through the mother's infected genital tract.
The only effective treatment for gonorrhea is antibiotic therapy.
Gonorrhea, more popularly known as gonorrhea, has been known since biblical times. Even then, the high degree of contagiousness of the disease was noted, the need to isolate the patient, and attempts at treatment were made (washing, astringents and antiseptics). However, such therapy did not have the desired effect and the disease often led to death. Only with the advent of antibiotics in medicine in the middle of the last century did a complete cure become possible.
Cause and routes of infection
Gonorrhea is a purulent infection that develops as a result of contact with the mucous membranes of the gram-negative gonococcus Neisseria gonorrhoeae.
The main route of infection is unprotected sexual intercourse, as a result of which the organs of the genitourinary system are predominantly affected. In everyday life, the pathogen is transmitted from the carrier through household items, and during childbirth - from mother to newborn.
Signs of gonorrhea
After a short incubation period (from 3 to 7 days), after the introduction of the pathogen into the body, symptoms of infection appear, and in men almost always, and in women only in half of the cases. Characteristic signs of gonorrhea are:
- purulent discharge from the urethra or vagina;
- itching, burning in the external genital area;
- pain during urination and frequent urge to urinate;
- in men, pain may spread to the perianal area.
The listed symptoms are characteristic of the acute form of the disease. Without appropriate treatment, the infection spreads to the pelvic organs, kidneys, the pathogen enters the blood (bacteremia), and the skin and joints are affected. Gonorrhea enters a chronic stage, which has little external manifestation, but leads to serious complications. Women who have no external manifestations of the disease often suffer from infertility.
Antibiotics for gonorrhea in men and women
Antibacterial therapy is the only way to treat this STD (sexually transmitted disease). At the same time, doctors, when selecting treatment, are guided not only by the social significance of the disease, but also by the risk of developing severe complications. According to international standards, the resistance of gonococci to the prescribed drug should not exceed 5%.
In this regard, constant monitoring of the effectiveness of drug therapy is carried out in all regions. The causative agent of gonorrhea has several mechanisms for developing resistance to antibiotics, so over time, generally accepted treatment regimens lose their relevance.
At the moment, gonococci are sensitive to drugs such as ceftriaxone ®, cefixime ®, cefotaxime ®, spectinomycin ®, ciprofloxacin ®, ofloxacin ®. But penicillin ® no longer helps against gonorrhea, nor does tetracycline.
In addition, new strains resistant to fluoroquinolones and cephalosporins are emerging.
At the moment, several strains of infection have been identified that are completely resistant to antibacterial therapy.
In modern dermatovenerological practice, several antibiotics are used to treat gonorrhea. At the same time, they are divided into main and reserve (the second group is prescribed in case of intolerance or ineffectiveness of the first). In addition, macrolides are used to prevent chlamydia as a concomitant infection.
Ceftriaxone ®
Ciprofloxacin ®
Belongs to the group of fluoroquinolone antibiotics that suppress the biosynthesis of bacterial cell DNA. It has a bactericidal effect against gram-negative pathogens, causing additional destruction of the cell wall.
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Widely used for purulent inflammatory processes of various localizations. Contraindicated in case of kidney and liver dysfunction, hypersensitivity to fluoroquinolones, pregnant and breastfeeding women, as well as persons under 18 years of age. Ciprofloxacin ® , like ceftriaxone ® , is the drug of choice for gonorrhea and is administered once orally.
For the treatment of gonococcal urethritis or cervicitis, a single dose of 500 milligrams of the drug is prescribed.
Ofloxacin ®
Spectinomycin ®
A tricyclic antibiotic from the aminoglycoside class that has a bacteriostatic effect on bacteria.
Penetrating into the cell, it interferes with the biosynthesis of protein necessary for growth. It is active primarily against gram-negative microorganisms, including gonococci. It has low toxicity and, accordingly, a small list of contraindications and side effects. For uncomplicated gonorrhea it is a reserve drug, and for infections with complications it is one of the main ones.
Cefotaxime ®
A third generation cephalosporin antibiotic intended for parenteral administration has been successfully used for the treatment of respiratory and urogenital infections.
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Prevents the formation of the cell wall of pathogenic bacteria, destroying it. Contraindicated in persons with individual intolerance to beta-lactams, severe AV blockade, gastrointestinal bleeding, and nonspecific ulcerative colitis. The injection is given once in a dose of 1 gram.
Cefuroxime ®
Reserve antibiotic of the cephalosporin group (2nd generation), intended to combat inflammatory diseases of the respiratory system, genitourinary system, and musculoskeletal system.
Available in various dosage forms, including for parenteral administration. Pregnant, lactating, premature children are prescribed with caution. Contraindicated in patients allergic to beta-lactams.
For gonorrhea, 1.5 grams of antibiotic is prescribed once.
Lomefloxacin ®
Another antibiotic taken for gonorrhea once orally.
Refers to fluoroquinolones, has a bactericidal effect on pathogenic microorganisms. The main purpose of the drug is the treatment of urogenital infections (both complicated and uncomplicated). Additionally, it can be used in combination with other drugs for antibiotic therapy of tuberculosis. Contraindicated for children, pregnant women, and people with hypersensitivity to fluoroquinolones. For gonorrhea it is included in the list of reserve medicines.
Cefixime ®
This third generation cephalosporin is effective against a wide range of pathogenic bacteria and is prescribed for inflammatory processes of the respiratory and urinary organs.
In the treatment of complicated gonorrhea, Cefixime ® is taken orally, being a reserve medication. It is used according to a scheme drawn up by a doctor in accordance with the severity and nature of the complication. Like other cephalosporins, it is characterized by low toxicity and a small number of contraindications (individual intolerance).
Azithromycin ®
The first representative of the azalide subclass from the group of semisynthetic macrolide antibiotics.
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It acts bacteriostatically due to the suppression of protein synthesis, and with increasing dose it exhibits a bactericidal effect. The spectrum of antimicrobial activity includes most known gram-negative, gram-positive and atypical pathogens. Due to its powerful therapeutic effect and convenient dosage regimen, it is widely used in various fields of medicine, exhibiting low toxicity.
Unlike the antibiotics listed above, Azithromycin ® for gonorrhea is not used to treat the underlying disease, but to prevent chlamydia. This infection often accompanies gonococcal infection, so taking azalides is necessary for preventive purposes. In parallel with the injections, a single dose of 1 gram of Azithromycin ® is prescribed for any form of the underlying disease, with the exception of cases when therapy is carried out in pregnant women (they can take erythromycin or spiromycin ®).
Doxycycline ®
It is an alternative to the previous drug used for the prevention of chlamydia in case of hypersensitivity to macrolides.
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Belongs to the group of tetracycline antibiotics and has a bacteriostatic effect on chlamydia. Unlike Azithromycin ® , which is taken once, Doxycycline ® is prescribed in a seven-day course. At the same time, the inherent toxicity of tetracyclines causes a list of contraindications: childhood, pregnancy, liver failure, allergies.
Antibiotic regimens for gonorrhea
There is no single principle for treating this disease, since it can occur in acute and chronic forms with complications. It is also necessary to adjust prescriptions and doses according to age and individual characteristics.
Guided by the requirements for the effectiveness and safety of antibiotic therapy, dermatovenerologists use the following regimens:
- acute gonorrhea, localized in the lower parts of the genitourinary system, is treated with a single injection of 250 mg of Ceftriaxone ® intramuscularly or with one oral dose of Ciprofloxain ® or Ofloxacin ® (500 or 400 mg, respectively). In case of intolerance, drugs from the reserve group are prescribed. To prevent chlamydia, take 1 gram of Azithromycin ® once in parallel (or Doxycycline ® - 100 mg twice a day for a week).
- Antibiotics for chronic gonorrhea, which occurs with complications, as well as for disseminated infection, are administered intramuscularly or intravenously for 24-48 hours until objective improvement. Prescribe Ceftriaxone ® (1 gram IM or IV once a day), Cefotaxime ® (1 g IV at eight-hour intervals), Spectinomycin ® intramuscularly or Ciprofloxacin ® intravenously every 12 hours (2 grams and 400 mg, respectively ). Subsequently, the patient is transferred to oral administration of Cefixime ® or Ciprofloxacin ®, determining the duration of the course in accordance with the nature of the complication.
- Treatment of newborns is carried out over a week by intravenous or intramuscular injections of a daily dose of the drug in two doses with a 12-hour interval. The daily amount of Cefotaxime ® is 25 mg per kg of body weight, and Ceftriaxone ® - from 25 to 50.
- When the mucous membranes of the pharynx are damaged, gonococcal pharyngitis is formed. With this diagnosis, gonorrhea is treated with Ciprofloxacin ® and other drugs according to the treatment regimen for the acute uncomplicated form.
- Gonococcal conjunctivitis is treated in adults with a single intramuscular injection of one gram of Ceftriaxone ®, and in newborns with one intramuscular or intramuscular injection.
- Antibiotic therapy during pregnancy is carried out at any stage in accordance with the severity of the disease. The main drugs in this case are Spectinomycin ® or Ceftriaxone ® , and fluoroquinolones and tetracyclines are strictly contraindicated.
The given treatment regimens for gonorrhea are for informational purposes only and cannot be used for self-medication without consulting a dermatovenerologist. A visit to the doctor is mandatory, since successful treatment requires bacteriological analysis (including control) and specialist supervision.
Gonorrhea is a dangerous sexually transmitted sexually transmitted disease. It is characterized by damage to the mucous membrane of the genitourinary system by a pathogen such as gonococcus. For a man, this problem is fraught with epididymitis, prostatitis, and in particularly difficult cases, infertility.
- Unprotected sexual intercourse with an infected person. Up to 50% become infected as a result of one-time unprotected sex.
- As a result of unconventional sexual contacts, the pathogen can infect the rectum, oropharynx, and conjunctiva.
- When using contaminated sex toys.
The duration of incubation (latent period) in men is up to five days. Clinical manifestations can appear after three days from the time of infection.
The course of the disease occurs in acute, subacute or chronic form. The acute course of the disease lasts on average about two months. It is noteworthy that its duration varies depending on the personal characteristics of the body’s immune system.
Note: symptoms may be absent - this occurs with the torpid form. According to statistics, this is observed in every 10th infected man. In this case, the patient becomes especially dangerous as a spreader of infection.
Characteristics of the acute phase of the disease:
- After just a few days, a man may notice discomfort in the urethra, in particular itching.
- Itching, severe pain and burning occur during urination.
- Swelling and hyperemia of the urethral opening occurs.
- The discharge takes on a yellowish or greenish tint.
With a long course, the disease becomes chronic:
- The infection spreads to the posterior region of the urethra, resulting in an increased urge to urinate, accompanied by pain.
- The prostate gland and testicles are affected, and gonococcal prostatitis develops.
- There is a long erection, and in some cases – difficulties in defecation, accompanied by pain and burning.
- Swelling of the genital organs and inguinal lymph nodes is observed.
- During sexual intercourse, pain, burning and discharge mixed with blood occur.
- Fever, chills, high temperature, and severe headache occur.
Note: long-term chronic course of the disease can cause a lot of serious complications - vesiculitis, balanoposthitis, epididymitis. If the infection penetrates the internal organs, myocarditis, meningitis and even hepatitis can occur.
Treatment of gonorrhea
The principles of treating the disease include powerful antibacterial therapy. The effectiveness of the fight against gonococcus is guaranteed only by groups of antibiotics. In this case, the location of the infection does not matter.
Note: Before starting treatment, it is important to find out which drugs the gonococcal microorganism is most sensitive to. This is done during bacteriological examination.
Penicillins– a popular antibiotic used in etiotropic therapy. A wide range of venereologists use these drugs. However, due to recent research, penicillins have been replaced by a more effective group of drugs:
- Sulfonamides.
- Cephalosporins.
- Macrolides.
- Ciprofloxacins.
- Aminocyclotols.
Note: For 6% of patients, standard therapy is ineffective due to multidrug resistance of pathogen strains. It is also noteworthy that gonococcus rarely “travels” alone - in approximately 50% of cases it is accompanied by chlamydia.
Recommended list of antibiotics for the treatment of gonorrhea
Forms of gonorrhea | Drugs | Treatment period | Duration of admission |
---|---|---|---|
Uncomplicated course of gonorrhea | Norfloxacin, Ciprofloxacin, Ofloxacin, Lomefloxacin, Ceftriaxone, Pefloxacin, Azithromycin | Intravenously or orally | 3-5-7 days |
Complicated form of gonorrhea | Ciprofloxacin, Ofloxacin, Lomefloxacin, Pefloxacin, Azithromycin | Intravenously or orally | 7-10-14 days |
Urosepsis | Ciprofloxacin, Ofloxacin, Azithromycin | Intravenously or orally | 10-14 days |
Tsiprinol
The active ingredient is ciprofloxacin. Has a strong antibacterial effect. Used in the complex treatment of gonorrhea and related diseases. The dose setting depends on the severity of the disease. In acute cases of the disease, 250 mg is prescribed once or 125 mg in the morning and evening.
Contraindications | Possible side effects |
---|---|
Hypersensitivity to fluoroquinolones | Rarely eosinophilia, leukocytosis, bone marrow suppression |
Concomitant use with tizadine is prohibited. | Dizziness, headache, depression, tremors, seizures |
Changes in taste, vision problems, temporary hearing loss, hives |
|
Respiratory system disorders, gastrointestinal disorders, renal failure are rare |
Popular analogues:
- Ciprobay;
- Tsiprolet;
- Tsifran;
- Ecotsifol.
Zoflox
A drug from the ofloxacin group, it has a bactericidal effect on gram-negative bacteria and is able to fight gram-positive ones. Its action is to block DNA gyrase of harmful microorganisms. Relevant for the treatment of uncomplicated gonorrhea. The dosage is up to 800 mg per day in several doses.
Contraindications | Possible side effects |
---|---|
Allergic reaction to fluoroquinolone derivatives | Urticaria, itching, erythema |
After TBI, stroke, brain diseases | Nephritis, renal failure |
Epilepsy | Dizziness, depression, insomnia, convulsions, tremors, hallucinations |
Uncompensated hypoglycemia | Respiratory system disorders, increased kidney enzyme levels, intestinal problems |
Arrhythmia, arterial hypotension, diabetes mellitus, anaphylactic shock |
Popular analogues:
- Tarvid;
- Zanotsin.
Azaran
A drug from the third generation cephalosporin group, it inhibits the synthesis of the wall of a harmful microorganism. It is used for uncomplicated gonorrhea intramuscularly in a volume of 250 ml once.
Popular analogues:
- Rocephin;
- Longacef;
- Tsefson.
Kirin
The active ingredient is spectinomycin, a tricyclic antibiotic from the aminocyclotol category. Affects gonococcal strains, is active against some gram-negative strains. Inactive against chlamydia. Used to treat complicated and uncomplicated gonorrhea. The dosage reaches up to 10 ml in severe cases.
Popular analogues:
- Trobitsin.
Suprax
The main active drug is cefixime. Dosage for adults for uncomplicated gonorrhea is 400 mg once. In case of a complicated form, the course of treatment is extended to 7-14 days of taking the drug.
Popular analogues:
- Cemidexor;
- Ixim Lupine;
- Ceforal Solutab;
- Cefspan;
- Pantsef.
Azicide
The active ingredient is azithromycin, a group of macrolide antibiotics. Effective for both gonorrhea and chlamydia. The dosage depends on the severity of the disease.
Popular analogues:
- Azimicin;
- Azitrox;
- Zimaks;
- Sumamed;
- Ecomed.
Treatment of acute gonorrhea in men
It is important to direct a comprehensive fight against the pathogen. For uncomplicated gonorrhea in men, the standard dose is 250 mg. Ceftriaxone(i.m. or i.v.) in combination with Azithromycin, 1 g orally once or similar preparations. If the patient has an allergic reaction to cephalosporins, the dose of azithromycin is increased to 2 g once. Symptoms usually disappear within 3-4 days. This scheme is also relevant for gonococcal pharyngitis, proctitis and conjunctiva.
Therapy for complicated gonorrhea
Such therapy always depends on the type of complication. The most popular drugs remain Ceftriaxone And Azithromycin. But the course of treatment in men is extended from a week to two. In especially severe cases, for example, with an infectious lesion of the heart, the course is increased to a month. The dosage also changes - doses of up to 2 g are prescribed every 6-12 hours. The dosage depends on the severity of the patient's condition. Treatment is carried out under the strict supervision of a doctor. Complicated forms of the disease are very dangerous and can cause death.
Fighting the chronic form
In this case, it is important not only to organize competent antibiotic treatment. The stages of rehabilitation are much more complex and broader:
- The urethra is washed.
- Immunomodulatory drugs are administered.
- Physiotherapy courses are prescribed - electrophoresis, phonophoresis, ultrasound;
Enzymes accepted:
- Trypsin.
- Chymotrypsin.
- Avelizin.
- Streptokinase.
- Lidaza.
- Ribonuclease.
Biogenic stimulants are involved.
These procedures use:
- Chlorhexidine.
- Collargol.
- Protargol.
- Silver nitrate.
- Potassium permanganate.
Note: injections or pills? – When fighting an infectious pathogen, injections will be more effective, since in this form the medicine penetrates the tissues better.
The following points are important during treatment:
- It is necessary to observe complete sexual rest.
- Both sexual partners should undergo therapy.
- Strong physical stress on the body is excluded.
- It is advisable to avoid cycling.
- Avoid being in the cold.
- Give up bad habits for a while.
Video - Symptoms and treatment of gonorrhea
Cure gonorrhea with one injection?
Unfortunately, such assurances from drug manufacturers and miracle doctors are outright lies. No such modern standard has yet been adopted in official practice. Medical treatment involves the use of a complex of antibiotics. In addition, most of the outdated drugs, which are actively prescribed to a wide range of patients to this day, are considered ineffective.
Ginseng tincture - a folk remedy to combat gonorrhea
It is important to use folk remedies in combination with therapeutic ones.
- A popular herbal infusion based on ginseng, which can be purchased at any pharmacy. In the morning, take up to 4 drops with food.
- A good recipe for a strong herbal mixture - 1 tbsp. l. corn silk, licorice root, ground bearberry and crushed birch leaves. The herbs are mixed together; to prepare the decoction, take 2 tbsp. l. Prepare the mixture and pour 250 ml of boiling water. Boil the infusion for 15 minutes. for a couple. When the broth evaporates, add water to the original volume. Drink during the day throughout the week.
- Brew ground juniper fruits, crushed birch leaves and dandelion roots. 3 tbsp is enough. l. mixture for 1 cup boiling water. Infuse the decoction for 30 minutes and drink 1 tsp. 15 minutes before meals, 3 times a day.
- To maintain immunity, a decoction of Schisandra chinensis will help - half a tsp. per glass. Natural fresh honey will give the best effect.
- In combination, you should take a decoction of diuretics - for example, parsley - 2 tbsp. l. per glass - and smooth hernia - 1 tsp. per glass. Both infusions are drunk in small portions - 2 tbsp. l. 3 times a day.
Video - How to treat gonorrhea with traditional methods
Gonorrhea prevention
- Maintaining protected sex.
- Strict adherence to personal hygiene standards - regular hand washing after visiting the toilet.
- Using personal sex toys.
Note: after unprotected sexual intercourse, a man should immediately urinate, wash the penis with soap and apply liberally Miramistin. This procedure will reduce the risk of infection not only with gonorrhea, but also with trichomoniasis, and even syphilis. For prevention, you can take a single dose of an antibiotic.
Conclusion
Due to the acquisition of resistance to antibiotics, gonorrhea becomes a disease that is very difficult to treat. The human body does not develop immunity to the pathogen, so no one is immune from re-infection. In this case, the old treatment regimen will be ineffective. In relation to the body, the new antibacterial therapy will be tougher and more aggressive than the previous one. The best way out and preventative measure is to have a reliable sexual partner and be faithful to each other.
Note: remember, self-medication is dangerous to your health! Online consultations cannot replace a timely in-person visit to a doctor!
29.06.2017
Gonorrhea is a sexually transmitted disease caused by the microorganism Neisseria gonorrhoeae. Gonorrhea is the most common sexually transmitted disease.
Neisseria gonorrhoeae affects the reproductive and urinary organs, and also affects the rectum, oral cavity and larynx.
Gonococci are found in leukocytes and epithelial cells and, at a moment unfavorable for the body, they are activated and multiply, and form colonies of microorganisms, which contributes to inflammation of the infected organ and its destruction.
The main route of infection with gonorrhea is sexual contact. You can also become infected from oral and anal sexual contact.
The incubation period of the disease is 3-5 days in the male body and 5 days in the female body.
Methods of transmission of gonorrhea infection
Methods of transmission of gonorrhea are:
- method of transmission during sexual relations;
- spread of infection at the household level;
- from an infected pregnant mother to her child at the time of birth.
Factors that increase the risk of contracting an infection include:
- early sexual life;
- sexual contacts that are not protected by a condom;
- regular change of partners;
- promiscuous sex life;
- presence of gynecological diseases;
- long-term use of hormonal drugs;
- stressful situations to which a person is exposed.
Signs of Neisseria gonorrhoeae development in the body
The first symptoms and signs of gonorrhea in the body are:
- unpleasant and painful sensations in the urethra;
- pain in the lower abdomen;
- purulent discharge from the urethra and vagina;
- burning during urination and itching;
- frequent urination;
- redness and swelling of the urethra;
- inflammation of the labia minora and labia majora;
- purulent particles appear in the urine.
Diagnosis of gonorrhea and stages of examination
Before carrying out treatment, it is necessary to diagnose and take tests for gonococcus infection. External examination of the patient cannot guarantee the diagnosis. It is necessary, first of all, to visit the office of a venereologist, who will examine the patient and refer him for tests.
Only after the patient’s genital organs have been examined, as well as the results of laboratory tests, can a diagnosis be made and prescribedwhat antibiotics to take for gonorrhea.
In order to establish the correct diagnosis, it is necessary to conduct a number of studies.
Diagnosis of gonorrhea is divided into several stages:
- bacterioscopic examination;
- bacteriological examination;
- epidemiological history;
When examining for gonococci, it is imperative to carry out molecular biological tests:
- PCR;
- blood test using enzyme immunoassay;
- GEN PROBE.
The use of antibiotics in the treatment of gonococcal infection
The treatment regimen for gonococcal infections in the body with antibiotics is taking tablets and injections with antibiotics.Antibiotics for gonorrheadepend on the stage of development of the disease. At the initial stage of the disease, you can use treatment with tablets:
- Cefixime – taken orally, one tablet of 400 mg. It may be used during pregnancy.
- Ciprofloxacin - orally, once 500 mg for gonorrhea at the initial stage of infection. If the body, in addition to gonorrhea, has the disease chlamydia, in this case the course lasts up to 10 calendar days. It is not recommended to take this drug during pregnancy.
- Ofloxacin - orally, once 400 mg. If, in addition to gonococcal infection, the body suffers from chlamydia and ureaplasmosis, treatment is carried out for 10 - 15 days. The drug should not be used during pregnancy.
At the time of drug treatment of gonorrhea, it is necessary drink tablets, use antiseptic suppositories, antiseptic solutions and ointments.
For acute infections, you can treat with pills, but treat gonorrhea with intramuscular injections will take much less time and the side effects of antibiotics on the body will be much less. Tablets are taken only at the initial stage of gonorrhea, and in other cases medication treatment carried out using injections:
- Ceftriaxone – once intramuscularly 250 mg. The drug is diluted with novocaine or icecaine. The drug is used during pregnancy. In advanced forms of gonorrhea, Ceftriaxone is administered intravenously once a day for two weeks.
- Spectinomycin – once intramuscularly 2000 mg. The drug is used during pregnancy. An advanced form of the disease is treated for two weeks with the same dosage of the drug.
Medicines for gonorrhea for women and men
When treating a diseasegonorrhea, antibioticsleads to disturbances in the microflora of the female body, which can lead to vaginitis, both fungal and bacterial. Therefore, antibiotic therapy must be combined with the intake of probiotics and the use of local antifungal therapy:
- suppositories containing lactobacilli (Efkomin, Laktonorm, Acylact, Lactobacterin);
- vaginal suppositories containing antifungal drugs (Isoconazole, Clotrimazole, Candide, Kanison, Candibene).
Treatment with vaginal suppositories is carried out only before bedtime and for at least 10 calendar days.
Also, local antiseptic drugs are used during pregnancy, if taking medications orally is prohibited.
Local antibiotic therapy is used in cases of:
- inflammatory processes in the external organs of the genital area - warm baths with a decoction of chamomile, calendula or potassium permanganate;
- inflammatory processes in the urethra (urethritis) - douching of the urethra with the drug protargol and collargol;
- vaginal inflammation - anti-inflammatory and antiseptic suppositories.
During menstruation, the use of vaginal suppositories is contraindicated.
Treatment of gonococcal infection with medications for men and women is identical. The only difference is in the use of local antiseptic drugs. To wash the urethral canal, solutions of potassium permanganate and chlorhexine are used. In case of skin damage in the genital area, baths with furatsilin and potassium permanganate should be used.
Drugs for the treatment of mixed forms of gonorrhea
Quite often, gonococcal infection is transmitted together with other sexually transmitted infections, such as chlamydia, ureaplasma and spirochete pallidum.
If additional infections are diagnosed in the body, treatment with fluoroquinolone antibiotics is prescribed, and the course of drug treatment continues until the body is completely cleared of infections.
For the treatment of gonorrhea and chlamydia:
- Ciprofloxacin – once or a course of 10 days intramuscularly 500 mg;
- Ofloxacin - orally, 800 mg once a day, course of treatment for two weeks;
- Doxycycline - orally, 100 mg 1 or 2 times a day for a week;
- Erythromycin - 0.5 g orally 4 times a day, for 10 calendar days;
For the treatment of gonococcal infection and trichomoniasis:
- Metronidazole - 500 mg 2 - 3 times a day, course of treatment is one week;
- Tinidazole - 2g orally, 1 time per day, for 3 to 5 calendar days.
For the treatment of gonococcal infection and spirochete pallidum:
- Bicillin 5 - intramuscular injection, two procedures over 7 days;
- benzylpenicillin novocaine salt - injection intramuscularly, for 7 days, twice a day;
- Benzylpenicillin (novocaine salt) - injection intramuscularly, for 20 days, twice a day.
Consequences of gonorrhea
Incorrect treatment can lead to gonorrhea is not cured, but goes into a latent stage and waits for an opportunity to resume the reproduction of gonococci again.
The reasons why gonorrhea recurs and bacteria multiply rapidly:
- low immunity;
- very frequent treatment of the genitals with antiseptics;
- antibiotic treatment;
- failure to use intimate hygiene;
- using suppositories that contain antiseptics and antibiotics;
- use of intimate toys, including anal ones, in sex;
- oral sex during casual sexual contacts;
- sexual infections that exist in the body;
- many changing sexual partners.
If the disease recurs in both sexes, the temperature may rise.
The consequences of gonorrhea in the female body are:
- spread of the disease above the cervix;
- menstrual irregularities;
- endometritis of the uterus;
- pathology of the fallopian tubes;
- lesions of the ovaries and appendages;
- infertility.
The consequences of gonorrhea in the male body are:
- spread of disease in the prostate;
- erectile dysfunction;
- early ejaculation;
- chronic urethritis;
- sedentary spermatozoa;
- impotence;
- infertility.