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Optimized treatment of infections caused by antibiotic-resistant strains of Neisseria gonorrhoeae

Gonorrhea is one of the most common sexually transmitted infections, both in the world and in USA. The main problem in the treatment of this infection is the emergence of antibiotic resistant strains of Neisseria gonorrhoeae. The recent increase in the detection rate of strains resistant to ciprofloxacin has necessitated the switch from a relatively inexpensive regimen of oral ciprofloxacin to a more expensive injectable ceftriaxone. In addition, surveillance for antimicrobial resistance requires cultural studies, however, non-cultural methods for diagnosing gonorrhea are rapidly replacing cultures.

The study in the United States aimed to determine the most favorable combination of diagnostic methods in terms of cost-effectiveness (culture studies followed by antibiotic susceptibility tests vs tests not cultural) and therapeutic regimes (ciprofloxacin vs ceftriaxone) with gonococcal infection under conditions of increasing resistance of Neisseria gonorrhoeae to ciprofloxacin.

The diagnostic and treatment strategies for gonococcal infections considered during the study were just as effective (over 99%).

As the results of the study showed, the change in regimen from ciprofloxacin to ceftriaxone was accompanied by a reduction in the cost of treatment (i.e. it was optimal) in the cases where the prevalence of gonococcal infection in the population exceeded 3% and resistance to ciprofoxacin exceeded 5%. At the same time, conducting cultural studies and determining the sensitivity of microorganisms were the optimal strategy for the incidence of gonorrhea in the population of less than 13%, while non-cultural research methods were optimal in terms of cost minimization with a prevalence of gonococcal infection of more than 13%.