Gonorhoea
26 years old woman was treated for gonorrhea. Due to allergy to beta-lactam antibiotics found in her history, single dose of intramuscular spectinomycin was administered and a prescription for 7-days peroral therapy with doxycycline was issued.
Two weeks later she returned to the hospital with mucopurulent cervicitis. By taking the anamnesis she admitted that she had lost the prescription for doxycycline and thus was not treated with doxycycline.
Questions:
1. Was the original therapy of gonorrhea correct?
2. To which group belong spectinomycin and what are its major adverse effects?
3. What kind of alternative therapy would you recommend for gonorrhea in case the patient is not allergic to beta-lactam antibiotics?
4. What can be the reason for developing the mucopurulent cervicitis?
5. How would you treat her actual clinical situation? (Choose the most correct answer and explain why)
a) to wait with the therapy until the real pathogen is identified
b) to prescribe doxycycline again
c) to administer single peroral dose of cefixim in the hospital
d) to administer single peroral dose of azithromycin in the hospital
e) to prescribe erythromycine for 7 days peroral therapy
6. What kind of therapy would you use in case the patient is pregnant?
7. Which groups of antibiotics are contraindicated in pregnancy?