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Chapter 10 : Use of Quinolones for Treatment of Sexually Transmitted Diseases

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Abstract:

Bacterial sexually transmitted diseases (STDs) are a global public health problem. The annual incidence of bacterial STDs exceeds 100,000,000. Unrecognized, asymptomatic, or latent infections may make this number closer to 200,000,000. A table depicts the bacterial STDs that are discussed in this chapter and identifies acute presentations and sequelae. Bacterial STDs, specifically those caused by and , are responsible for serious morbidity in women including pelvic inflammatory disease, ectopic pregnancy, tubal infertility, chronic pelvic pain, neonatal infection, and increased risks of acquiring or transmitting human immunodeficiency virus (HIV). Heterotypic resistance was found in up to 69% of isolates each year, and patients with this pattern of resistance were more likely to fail therapy. Heterotypic resistance to the quinolones was recently reported in three patients whose isolates were resistant to doxycycline, azithromycin, and ofloxacin at concentrations > 4.0 mg/liter. Ofloxacin is now an alternate regimen for treatment of chlamydial infection in both the Canadian and U.S. treatment guidelines. The quinolones were found to be excellent drugs for the treatment of gonococcal infection. The fluoroquinolones, especially ciprofloxacin, were effective single-dose therapeutic agents for . Granuloma inguinale is a cause of genital ulceration in some parts of the world, including Southeast Asia, India, Australia, and South Africa. Ofloxacin, levofloxacin, and perhaps sparfloxacin provide equivalence to doxycycline for the treatment of infections.

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
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Tables

Generic image for table
Table 1

Clinical manifestations of bacterial STDs

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 2

In vitro activity of quinolones and other agents against

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 3

Treatment trials of oral quinolones for genital chlamydial infections

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 4

In vitro activity of quinolones versus

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 5

Treatment trials of oral quinolones for gonococcal infections up to 1996

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 6

Treatment trials of oral quinolones for gonococcal infections, 1997 to 2001

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 7

Treatment trials of oral quinolones for gonococcal infections at other body sites

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 8

Treatment regimens and the development of quinolone-resistant phenotypes

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 9

In vitro activity of quinolones against and

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 10

Treatment of nongonococcal urethritis and cervicitis

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 11

Activity of quinolones and other agents against

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 12

Treatment of infection: clinical trials

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10
Generic image for table
Table 13

Pelvic inflammatory disease trials: comparative studies

Citation: Peeling R, Ronald A. 2003. Use of Quinolones for Treatment of Sexually Transmitted Diseases, p 171-192. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.ch10

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