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Vol. 37. Issue 7.
Pages 458-466 (August - September 2019)
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Vol. 37. Issue 7.
Pages 458-466 (August - September 2019)
Continuing medical education: sexually transmitted infections
DOI: 10.1016/j.eimce.2018.12.007
Gonococcal infection: An unresolved problem
Infección gonocócica: un problema aún sin resolver
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Maria Jesús Barberáa,b,c,d, Judit Serra-Pladevallb,d,e,f,
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juserra@vhebron.net

Corresponding author.
a Unidad de ITS Vall d’Hebron-Drassanes, Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d’Hebron, Barcelona, Spain
b Vall d’Hebron Institut de Recerca, Barcelona, Spain
c Universitat de Barcelona, Barcelona, Spain
d GeITS de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
e Servicio de Microbiología, Hospital Universitario Vall d’Hebron, Barcelona, Spain
f Departamento de Genética y Microbiología, Universitat Autònoma de Barcelona, Barcelona, Spain
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Tables (6)
Table 1. Treatment recommendations for uncomplicated gonorrhoea in urethra, cervix or rectum.
Table 2. Treatment recommendations in gonococcal infection of the pharynx in adults and adolescents.
Table 3. Treatment recommendations in gonococcal orchiepididymitis and pelvic inflammatory disease.
Table 4. Treatment recommendations in disseminated gonococcal infection.
Table 5. Treatment recommendations for gonococcal conjunctivitis in adults.
Table 6. Treatment recommendations for gonococcal infection in children.
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Abstract

Gonococcal infection is a current public health problem worldwide, being the second most prevalent bacterial sexually transmitted infection. The etiologic agent is Neisseria gonorrhoeae, a Gram-negative diplococcus, and mainly causes urethritis in men. In women up to 50% of infections can be asymptomatic. N. gonorrhoeae has a great ability to develop antibiotic resistance, so the last remaining therapeutic option are extended spectrum cephalosporins. Many guides recommend dual therapy with ceftriaxone and azithromycin, but in recent years the resistance to azithromycin is also increasing, so that dual treatment is being questioned by scientific societies.

Keywords:
Gonococcal infection
Diagnosis
Treatment
Resumen

La infección gonocócica es un problema de salud pública a nivel mundial, siendo la segunda infección de transmisión sexual bacteriana más prevalente. El agente etiológico es Neisseria gonorrhoeae, un diplococo gramnegativo, y causa principalmente uretritis en hombres. En mujeres, hasta un 50% de las infecciones pueden ser asintomáticas. N. gonorrhoeae tiene una gran capacidad de desarrollar resistencia antibiótica, con lo que actualmente la última opción terapéutica son las cefalosporinas de espectro extendido. Muchas guías recomiendan la terapia dual con ceftriaxona y azitromicina, pero en los últimos años la resistencia a esta última también está aumentando, con lo que el tratamiento dual se está poniendo en duda por parte de las sociedades científicas.

Palabras clave:
Infección gonocócica
Diagnóstico
Tratamiento

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