Gonorrhea is an infectious inflammatory disease of urogenital mucosa caused by Neisseria gonorrhoeae, which is directly transmitted through sexual contact. Among all kinds of sexually transmitted diseases, gonorrhea has the highest incidence. Because some female patients are asymptomatic carriers, coupled with the emergence of penicillinase-resistant strains and antibiotic-resistant strains, it is difficult to prevent and treat gonorrhea, which has become a key disease in sexually transmitted diseases.
Humans are the only natural hosts of Neisseria gonorrhoeae. Gonorrhea is mainly transmitted through sexual intercourse, but also indirectly through clothes, bedding, bedpans and medical devices contaminated by patients' secretions, especially for young girls. Newborns can be infected through the birth canal of pregnant women with gonorrhea, causing gonococcal conjunctivitis. Gonorrhea mainly occurs in sexually active young people. Clinically, 5%-20% of infected people may have no obvious symptoms, which may easily lead to misdiagnosis and missed diagnosis.
If treatment is timely and reasonable, acute gonorrhea can be completely cured. Symptoms that last for more than two months are called chronic gonorrhea. Chronic gonorrhea is caused by patients who suffer from acute gonorrhea without treatment or unreasonable or incomplete treatment, excessive sexual life, alcoholism, decreased general resistance or other wasting diseases (such as tuberculosis, diabetes, tumor). Neisseria gonorrhoeae lurks in the folds of paraurethral gland, vestibular gland, cervical gland and fallopian tube in female patients with chronic gonorrhea for a long time. Although it is not easy to be found during inspection, it is still contagious.
Generally speaking, gonorrhea is the easiest to cure among all kinds of sexually transmitted diseases, but it is often more difficult to cure because of improper or incomplete treatment. There are three reasons why gonorrhea is difficult to be completely cured: first, there is no professional STD prevention and treatment institution for treatment (including lack of professional technicians and treatment principles); Second, whether gonorrhea is cured or not, blindly taking injections to take medicine; Third, no matter whether the illness needs it or not, abuse antibiotics, as long as patients are eager to treat the disease, they will use the top, latest and imported antibiotics. The above situation will inevitably lead to the emergence of gonorrhea drug-resistant strains too early and too fast, which will not only bring difficulties to treatment, but also lead to a more serious gonorrhea epidemic, which will cause great difficulties to the prevention and treatment of sexually transmitted diseases in China.
In order to avoid economic and physical losses, please go to a professional STD prevention and treatment institution in time after getting gonorrhea, so as to avoid misdiagnosis and mistreatment and cause lifelong regret.
(2) drug treatment of gonorrhea
Because Neisseria gonorrhoeae is sensitive to antibiotics, patients with acute infection without complications can get quick results and high cure rate as long as they use antibiotics in a timely and sufficient manner. At present, the commonly used drugs are as follows:
1, penicillin: 4.8 million units or 3 grams of ampicillin, daily 1 time, * * * 7 days to 14 days, 1 course of treatment.
2. Minocycline (minocycline): Take orally twice the first day, 200mg each time, and then twice a day, each time 100mg, for 4 days, for 1 course of treatment. For gonorrhea patients without complications, the cure rate can reach 100%. The medicine has the characteristics of high efficiency, rapidity and no serious side effects.
3, spectinomycin (Lin Bizhi): 2 grams for male patients each time, intramuscular injection of buttocks; Female patients were injected into the muscles on both sides of buttocks, 4g each time. After taking the medicine, the symptoms of dysuria and pus discharge are mostly obviously alleviated or disappeared within 3-5 hours. Generally, it can be cured within 3 ~ 5 days after the first treatment, and those who have been treated need to extend the medication time appropriately. The medicine is characterized by being effective in the treatment failure of penicillin, and can also be used for people who are allergic to penicillin.
4. Ceftriaxone (carbendazim): After intramuscular injection of 200 mg each time, the symptoms were obviously relieved 2-4 hours after injection, and disappeared after 24 hours. It is characterized by high curative effect, and the therapeutic purpose can be achieved by taking 1 time.
5. Cefotaxime sodium: every intramuscular injection 1g, the cure rate can reach over 95%. If probenecid 1g is taken at the same time, or 1% or 2% lidocaine is injected at the same time, the effect will be better. This medicine is effective for penicillin treatment failure.
6. Norfloxacin (Lin Dezhi or Lin Kexing): 800mg 1 time for patients with acute gonorrhea, once a day (or 400 mg/time, twice a day) for 3 days. Patients with chronic gonorrhea take 800 mg orally for the first time, and then 400 mg each time, three times a day, for 5 ~ 7 days; The cure rate can reach more than 95%.
7. Fluazinone: 400 mg for male patients, 600 mg for female patients, or 200 mg for both male and female patients, twice a day for 3-5 days, the cure rate can reach over 95%. The medicine can not only treat gonorrhea, but also treat nongonococcal urethritis.
8. ciprofloxacin (ciprofloxacin): acute gonorrhea patients: 65438+500 mg for 0 times, 500 mg for the next day if necessary. The cure rate can reach 99%.
9. Compound sulfamethoxazole: once 1g, twice a day, * * * 5 ~ 7 days. But clinically, it is not uncommon for gonorrhea to last for months or even years. Some patients are afraid of medical treatment, and the treatment is not timely, thorough and unreasonable (individual doctors, counterfeit drugs, inferior drugs, etc. ), so that gonorrhea continues to develop and become internal genital inflammation; One of the husband and wife has not been treated in time after illness, and still has sex life, or one of them has chaotic sex life, whoring, prostitution, etc. , will cause repeated infections; There are also drug-resistant strains, which reduce the relative efficacy of drugs. Although the symptoms can be alleviated after treatment, they cannot be cured. Once the disease is chronic, it will often leave behind future troubles, which will bring great difficulties to the treatment. To achieve a complete cure in clinic, it is necessary to repeat the smear and bacterial culture of urethral or cervical canal secretion 4 ~ 7 days after treatment, and then review it/kloc-0 times a month, and then take the medicine for 7 days, and the cure is negative for 3 consecutive months.
Attention should be paid to the following points during treatment: ① Gonorrhea is the first choice, followed by penicillin, and then other antibiotics. ② The dosage should be large, the time should be sufficient, and the method should be scientific. ③ The treatment should be thorough, that is, all the symptoms disappear, the urine is clear, and the smear of prostatic fluid or cervical secretion is negative. 4 both husband and wife or sexual partners investigate and deal with it together. ⑤ Don't listen to the travel doctor's remedies or "ancestral secret recipe", and use drugs indiscriminately during the treatment, so as not to delay the illness. ⑥ After being cured, lead a totally clean life, put an end to vagrancy and prevent reinfection.
Treatment of gonorrhea
treat cordially
1, processing principle:
(1) Regular treatment as soon as possible: once diagnosed, regular treatment should be given in time to avoid delaying the illness;
(2) Rational drug use: According to the sensitivity and drug resistance of Neisseria gonorrhoeae to drugs, the price of drugs, the convenience of use, the toxic and side effects of drugs and the patient's condition, the appropriate drugs are selected comprehensively;
(3) Careful treatment of complications: for patients with complications, the treatment dose should be sufficient and the course of treatment should be long enough, and combined drug treatment is needed to achieve the purpose of cure;
(4) Treating complications at the same time: For those with complications, gonorrhea and other sexually transmitted diseases should be treated to avoid paying attention to one thing and losing another;
(5) Pay attention to pregnant women and newborns: For pregnant women and newborns, special attention should be paid to the use of drugs, and all drugs that affect the growth and development of fetuses and newborns should not be used;
(6) Regular review and follow-up: those who have completed the course of treatment will be reviewed one week after treatment, and the clinical symptoms and signs will disappear, and those who have negative smear or culture results will be cured.
2. Treatment plan:
(1) Gonorrhea without complications: adopt one of the following schemes.
1) ceftriaxone: 0.25g, intramuscular injection once;
2) cefuroxime: 1.5g, once intramuscular injection;
3) ciprofloxacin: 0.5 g, taken suddenly;
4) Junofloxacin: 0.4g, taken suddenly;
5) Spectinomycin: 2-4g daily, intramuscular injection for 2-3 days;
6) Phthalocyanine toxin:1.5g. Take it suddenly and take 1.0g probenecid at the same time.
(2) Disseminated gonorrhea: one of the following schemes is adopted for treatment.
1) ceftriaxone: 1.0g, intravenously or intramuscularly, 1 time daily for 7 days;
2) Spectinomycin: 2.0g, intramuscular injection, twice a day for 7 days.
(3) Gonococcal ophthalmia:
1) Adult gonococcal ophthalmia: ceftriaxone 1.0g, intramuscular injection once;
2) Neonatal gonococcal ophthalmia: One-time intramuscular injection of ceftriaxone (25-50mg/kg).
3) In addition to systemic medication, wash the affected eyes with normal saline once every 30-60 minutes, ***6 times.
4) Gonorrhea in children: ceftriaxone 125mg, once intramuscular injection. Suitable for patients without complications.
5) Complications and complications of gonorrhea: those with severe gonorrhea should be hospitalized.