Interesting Article of the Week: Gonorrhea, Superbug.

The Emerging Threat of Untreatable Gonnococcal Infection.
Bolan GA, Sparling PF, Wasserheit JN
N Engl J Med 2012;366(6):485

This article was generated by the CDC and is about the increasing incidence of drug resistance of Neiseria gonorrhoeae, as well as the CDC’s newest recommendations for the treatment of gonorrhea.  Gonorrhea has slowly and inexorably conquered an impressive list of antibiotics, including penicillin, tetracycline and, most recently, flouroquinalones.  Currently, only two antibiotics remain for treatment of gonorrhea, and sure enough, signs of resistance to these two drugs are cropping up in Asia. Continue reading

Question of the Week: STD’s–Test or Just Treat?

Reader Question of the Week:

How do I go about convincing the management team to allow me to treat inmates for STI’s.  It is common practice to obtain a UA for c/o burning etc per protocol.  But, I am not allowed to move forward with determining if they have an STD if the UA is negative and s/s persist.  I am told there was previous funding for this, but was lost with budget cuts.  I am tempted to treat these inmates per WA State Department of Health Guidelines for STD management anyway.  Would this be wrong?  How would I know what to give them? I would be guessing.  I am thinking azithromycin 1 gm and flagyl 500 mg po bid x 7 days?  Comments? Continue reading