1. Efficacy of 1 g Ceftriaxone Monotherapy Compared to Dual Therapy With Azithromycin or Doxycycline for Treating Extragenital Gonorrhea Among Men Who Have Sex With Men.
- Author
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Aoki, Takahiro, Mizushima, Daisuke, Takano, Misao, Ando, Naokatsu, Uemura, Haruka, Yanagawa, Yasuaki, Watanabe, Koji, Gatanaga, Hiroyuki, Kikuchi, Yoshimi, and Oka, Shinichi
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EPIDEMIOLOGY of sexually transmitted diseases , *DRUG efficacy , *CEFTRIAXONE , *GONORRHEA , *SCIENTIFIC observation , *PHARYNGEAL diseases , *CONFIDENCE , *CONFIDENCE intervals , *CLINICAL trials , *TIME , *ORAL drug administration , *RECTAL diseases , *DOXYCYCLINE , *FISHER exact test , *COMPARATIVE studies , *MEN who have sex with men , *AZITHROMYCIN , *CHLAMYDIA trachomatis , *DATA analysis software , *LONGITUDINAL method - Abstract
Background Evidence on efficacy of high-dose ceftriaxone monotherapy for extragenital Neisseria gonorrhoeae (NG) infection is lacking. Methods A cohort of men who have sex with men (MSM) were tested for NG/ Chlamydia trachomatis (CT) every 3 months, in a single-center observational study in Tokyo, Japan. MSM aged > 19 years diagnosed with extragenital NG infection between 2017 and 2020 were included. A single dose of 1 g ceftriaxone monotherapy was provided, while dual therapy with a single oral dose of 1 g azithromycin or 100 mg doxycycline administered orally twice daily for 7 days were given, for those coinfected with CT, according to infected sites. Efficacy of these treatments was calculated by the number of NG-negative subjects at test-of-cure divided by the number of subjects treated. Fisher exact tests were used to compare the efficacy between the 2 groups. Results Of 320 cases diagnosed with extragenital NG, 208 were treated with monotherapy and 112 were treated with dual therapy. The efficacy against total, pharyngeal, and rectal infections was 98.1% (204/208, 95% confidence interval [CI]: 95.2–99.3%), 97.8% (135/138, 95% CI: 93.8–99.4%), and 98.6% (69/70, 95% CI: 92.3–99.9%), respectively, in the monotherapy group, whereas the corresponding efficacy in the dual therapy was 95.5% (107/112, 95% CI: 90.0–98.1%), 96.1% (49/51, 95% CI: 86.8–99.3%), and 95.1% (58/61, 95% CI: 86.5–98.7%), respectively. No significant difference in the corresponding efficacy was observed between the two groups (P = .29, P = .61, P = .34, respectively). Conclusions High-dose ceftriaxone monotherapy is as effective as dual therapy for extragenital NG among MSM. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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