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By Dr. Siana Shtilionova
Corresponding Author Dr. Siana Shtilionova
Dermatology Venerology, MU Varna, - Bulgaria
Submitting Author Dr. Siana Shtilionova
DERMATOLOGY

Gonococcical, Non- and Gonococcical Urethritis, Moxifloxacin

Shtilionova S. A New Therapeutic Scheme in Non- and Gonococcical Urethritis with Moxifloxacin. WebmedCentral DERMATOLOGY 2011;2(11):WMC002508
doi: 10.9754/journal.wmc.2011.002508
No
Submitted on: 27 Nov 2011 05:07:56 PM GMT
Published on: 28 Nov 2011 05:22:07 PM GMT

Abstract


Gonococcical and non-gonococcical urethritis are sex transmitted diseases in which treatment, dermatologists use different therapeutic scheme.
We offer a new one in which Moxifloxacin 400 mg / per day is used it is a chinolonic antibiotic with good bactericidic effect to gram-positiveve and gram-negative bacteria.
20 males (10 with gonococical urethritis and 10 with non-gonococcical urethritis) were treated with Moxifloxacin 400 mg /per day for 7 days.
Excellent results were observed in all 20 patients at the end of the treatment. Exudation stopped after the 3rd day.
No adverse events were observed during and after the end of the treatment.
Key word: Gonococcical, non-gonococcical urethritis, Moxifloxacin

Introduction


Gonococcal and non-gonococcal urethritis are sexually transmitted diseases, which occur in women and men. Gonococcal urethritis are one of the most often encountered sexually transmitted diseases. According to data from the WHO 25 million new cases are diagnosed annually as the disease is ranked the 4-th place after trichomonasis, chlamidial infection and condyloma acuminatum.  
It can be caused by N. gonorrhoeae, as after an incubation period of 1.6 up to maximum of 14 /fourteen/ days, leads to the development of an acute gonococcal urethritis in men.
Infection in women proceeds asymptomatic and develops chronic gonococcal infection.    
The most common non-gonococcal urethritis are caused by chlamydias, mycoplasma and trichomonas vaginalis.   
There are different therapeutic schemes for treatment of gonococcal and non-gonococcal urethritis. One of the modern therapeutic agents is Moxifloxacin.  It is of the quinolones group with activity against a large number of gram-positive and gram-negative pathogens. The bactericidal action of Moxifloxacin results from inhibition of the two II DNA topoisomerases, gyrase and topoisomerase IV, necessary for the bacterial replication, transcription and recovery.
Moxifloxacin can be eliminated by plasma with final elimination half-life approximately 12 /twelve/ hours.
The purpose of our survey is to assess the therapeutic result of the implementation of a new scheme for treatment of gonococcal and non-gonococcal urethritis with Moxifloxacin (Avelox - 0,400 mg).

Methods


We treated 20 /twenty/ men with acute gonococcal urethritis and 10/ten/ with non-gonococcal urethritis, of which:
Chlamydian - 6 patients
Trichomonas - 3 patients
Mycoplasma - 1 patient
In all patients the executed scheme was Moxifloxacin - 400 mg. for a period of 7 /seven/ days. The control examinations were held after the completion of treatment and 1 /one/ week after that.
It was reporting the exudation, the symptoms of urethral discomfort (burning and urinary urgency).
All of the patients were tested for HIV, Syphilis, Hepatit B and C, the results were negative.
The partners of all patients were treated prophylactic with Moxifloxacin 0,400 mg per day 5 /five/ consecutive days.
The laboratory proof of the etiologic agent in gonococcal urethritis was microscopic and in non-gonococcal urethritis - PCR and microscopic.
The end of the treatment, in all infected (100%) the subjective symptoms (burning, urethral exudation), have been suspended after the 3-rd day from the beginning of the treatment.
One week after the completion of the therapeutic scheme urethral exudation was not registered in no one from the treated patients. In those of the patients with non-gonococcal urethritis an excellent result was achieved in 5 (83.3 %) of the patients. PCR was negative. In 1(16.7%) patient the result was recorded as very good, because of the availability of passing subjective symptoms from mild burning when urinating. In other sick with mycoplasma and trichomonas urethritis, the result was excellent, expressing the complete absence of subjective symptoms.
At the time of the treatment have not been reported adverse reactions in the two groups treated patients. The patients with non-gonococcal urethritis were traced one week after the completion of the healing scheme. Objective and subjective symptoms of the disease were not read. Control laboratory and microscopic tests were negative.

Conclusion


1. Moxifloxacin is a quinolone antibiotic with a good therapeutic effect on acute gonococcal and non-gonococcal urethritis, treating the objective and subjective symptoms for a short period of time - 3 /three/ days.
2. Moxifloxacin has a convenient for reception form: 1/one/ time daily 7/seven/ days.
3. During the reception according to the therapeutic scheme, no side effects are observed.
4. Moxifloxacin is an agent of treatment of acute gonococcal and non-gonococcal urethritis.

Bibliography


1. Carlin EM, Barton SE Azitromycin as the first line treatment of non gonococcal urethritis (NGU): a study of follow up rates, contact attendance and patients treatment preference Int. J STD AIDS 1996.
2. Jones RB New treatments for Chlamydia trachomatis Amn J Obstet Gynecol 1991
3. Ridgway GL Advances in the antimicrobial therapy of chlamydial genital infections 1998
4. Taylor- Robinson D The history of non-gonococcal urethritis. Sex transm Dis 1996
5. Taylor- Robinson D Furr PM Genital mycoplasma infections. Wien Klin Wochenschr 1997.

Source(s) of Funding


None

Competing Interests


None

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