Prevention and Treatment

Prevention depends on abstinence, monogamous relationships, consistent use of condoms, and prompt identification and treatment of sexual contacts. No vaccine is available. A small percentage of gonococcal strains have developed resistance to most antimicrobial medications over the years, but aside from penicillin and tetracycline, widespread resistance has not yet occurred in the United States. Several fluoroquinolones, and cephalosporins such as ceftriaxone are effective against more than 95% of the N.

: strains encountered. Resistance is much more com mon in parts of the world where antimicrobial usage is unrestricted, and the importation of resistant strains is inevitable. ■ fluoroquinolones, p. 517 ■ cephalosporins, p. 515

Table 25.8 describes the main features of this disease.

Chlamydial Genital System Infections

Between 80% and 90% of college men with symptoms suggesting gonorrhea actually have other infections. From 25% to 40% of these students are infected with Chlamydia trachomatis, a common cause of sexually transmitted disease of men and women. Chlamydial infections mimic gonorrhea in several ways, including production of urethritis, and testicle and fallopian tube damage. Like N. gonorrhoeae, C. trachomatis attaches to sperm, and some have speculated that its rapid ascent to the fallopian tubes occurs by hitching a ride on sperm. The main importance of the infection is that it can produce pelvic inflammatory disease (PID) in women, damaging the fallopian tubes and promoting sterility or ectopic pregnancy. Most alarming, tubal damage can occur without symptoms. The infection in men can produce sterility by infecting the epididymis. Chlamydial genital infections have only been reportable nationally since 1995, and they substantially exceed the numbers of reported cases of gonorrhea. ■ chlamydia, p. 292

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