Ensuring effective treatment is cri

Ensuring effective treatment is critical. Based on surveillance trends, CDC recently updated its treatment
recommendations: gonorrhea at any anatomic site should be treated with a single 250 mg intramuscular dose of ceftriaxone plus either 1 g of azithromycin as a single oral dose or 100 mg of doxycycline orally twice daily for 7 days (8). If this recommended regimen cannot be used, two alternative treatment options exist for urogenital or rectal gonorrhea: 1) if ceftriaxone is not available, clinicians can consider Cefixime 400 mg as a single oral dose and either azithromycin 1 g as a single oral dose or doxycycline 100 mg orally twice daily for 7 days, or 2) if the patient is cephalosporin-allergic, clinicians can consider azithromycin 2 g as a single oral dose. If either of these two alternative regimens is prescribed, the patient should return in 1 week for a test of cure. CDC will continue to update treatment recommendations based on surveillance data and clinical research. In the United States, GISP is the foundation of gonococcal antimicrobial susceptibility surveillance and has successfully identified important shifts in antimicrobial susceptibility. GISP's effectiveness can be complemented through enhanced surveillance by local and state health departments. Clinicians can strengthen surveillance by maintaining vigilance for treatment failures, collecting isolates for susceptibility testing from such patients, and promptly notifying the local public health STD program. Local public health laboratories can contribute by maintaining or rebuilding capacity to perform culture for N. gonorrhoeae or partnering with laboratories that can. Laboratories that conduct gonococcal antimicrobial susceptibility testing are requested to promptly notify the ordering clinician and local STD control program of isolates with elevated cephalosporin MICs (cefixime MIC >0.25 /¿g/mL or ceftriaxone MIC >0.125/¿g/mL). Local and state health departments are encouraged to promptly notify CDC of suspected treatment failures or isolates with elevated cephalosporin MICs. Local and state STD control programs are encouraged to develop local response plans. When a suspected cephalosporinresistant infection is detected, local public health authorities should interview the patient and ensure adequate treatment and ensure that all recent partners are evaluated and treated appropriately. Working case definitions and more detailed guidance can be found in CDC s recently released cephalosporin-resistant N. gonorrhoeae public health response plan (14).

Hasil (Bahasa Indonesia) 1:

Memastikan pengobatan yang efektif sangat penting. Berdasarkan tren pengawasan, CDC baru saja diperbarui pengobatannyarecommendations: gonorrhea at any anatomic site should be treated with a single 250 mg intramuscular dose of ceftriaxone plus either 1 g of azithromycin as a single oral dose or 100 mg of doxycycline orally twice daily for 7 days (8). If this recommended regimen cannot be used, two alternative treatment options exist for urogenital or rectal gonorrhea: 1) if ceftriaxone is not available, clinicians can consider Cefixime 400 mg as a single oral dose and either azithromycin 1 g as a single oral dose or doxycycline 100 mg orally twice daily for 7 days, or 2) if the patient is cephalosporin-allergic, clinicians can consider azithromycin 2 g as a single oral dose. If either of these two alternative regimens is prescribed, the patient should return in 1 week for a test of cure. CDC will continue to update treatment recommendations based on surveillance data and clinical research. In the United States, GISP is the foundation of gonococcal antimicrobial susceptibility surveillance and has successfully identified important shifts in antimicrobial susceptibility. GISP's effectiveness can be complemented through enhanced surveillance by local and state health departments. Clinicians can strengthen surveillance by maintaining vigilance for treatment failures, collecting isolates for susceptibility testing from such patients, and promptly notifying the local public health STD program. Local public health laboratories can contribute by maintaining or rebuilding capacity to perform culture for N. gonorrhoeae or partnering with laboratories that can. Laboratories that conduct gonococcal antimicrobial susceptibility testing are requested to promptly notify the ordering clinician and local STD control program of isolates with elevated cephalosporin MICs (cefixime MIC >0.25 /¿g/mL or ceftriaxone MIC >0.125/¿g/mL). Local and state health departments are encouraged to promptly notify CDC of suspected treatment failures or isolates with elevated cephalosporin MICs. Local and state STD control programs are encouraged to develop local response plans. When a suspected cephalosporinresistant infection is detected, local public health authorities should interview the patient and ensure adequate treatment and ensure that all recent partners are evaluated and treated appropriately. Working case definitions and more detailed guidance can be found in CDC s recently released cephalosporin-resistant N. gonorrhoeae public health response plan (14).

Hasil (Bahasa Indonesia) 2:

Memastikan pengobatan yang efektif sangat penting. Berdasarkan tren pengawasan, CDC baru-baru ini diperbarui pengobatannya
rekomendasi: gonore pada situs anatomi harus ditangani dengan satu dosis 250 mg intramuskular ceftriaxone ditambah baik 1 g azitromisin sebagai dosis tunggal atau 100 mg doksisiklin oral dua kali sehari selama 7 hari (8). Jika rejimen ini dianjurkan tidak dapat digunakan, dua pilihan pengobatan alternatif yang ada untuk urogenital atau gonore dubur: 1) jika ceftriaxone tidak tersedia, dokter dapat mempertimbangkan Cefixime 400 mg sebagai dosis tunggal dan baik azitromisin 1 g sebagai dosis tunggal atau doxycycline 100 mg secara oral dua kali sehari selama 7 hari, atau 2) jika pasien cephalosporin-alergi, dokter dapat mempertimbangkan azitromisin 2 g sebagai dosis tunggal. Jika salah satu dari dua rejimen ini alternatif yang diresepkan, pasien harus kembali dalam 1 minggu untuk tes obat. CDC akan terus memperbarui rekomendasi perawatan berdasarkan data surveilans dan penelitian klinis. Di Amerika Serikat, GISP adalah dasar dari gonokokal surveilans kerentanan antimikroba dan telah berhasil mengidentifikasi perubahan penting dalam kerentanan antimikroba. Efektivitas GISP dapat dilengkapi melalui peningkatan pengawasan oleh departemen kesehatan setempat dan negara. Dokter dapat memperkuat pengawasan dengan mempertahankan kewaspadaan untuk kegagalan pengobatan, mengumpulkan isolat untuk pengujian kerentanan dari pasien tersebut, dan segera memberitahukan program STD kesehatan masyarakat setempat. Laboratorium kesehatan masyarakat setempat dapat berkontribusi dengan mempertahankan atau membangun kembali kapasitas untuk melakukan budaya untuk N. gonorrhoeae atau bermitra dengan laboratorium yang bisa. Laboratorium yang melakukan pengujian gonokokal kerentanan antimikroba diminta untuk segera memberitahukan pemesanan dokter dan program pengendalian STD lokal isolat dengan MIC cephalosporin tinggi (cefixime MIC> 0,25 / ¿g / mL atau ceftriaxone MIC> 0,125 / ¿g / mL). Departemen kesehatan setempat dan negara didorong untuk segera memberi tahu CDC diduga kegagalan pengobatan atau isolat dengan MIC cephalosporin tinggi. Program pengendalian lokal dan negara STD didorong untuk mengembangkan rencana respon lokal. Ketika infeksi cephalosporinresistant dicurigai terdeteksi, otoritas kesehatan masyarakat setempat harus mewawancarai pasien dan memastikan perawatan yang memadai dan memastikan bahwa semua mitra baru-baru ini dievaluasi dan diobati dengan tepat. Bekerja definisi kasus dan pedoman yang lebih rinci dapat ditemukan di baru-baru ini merilis N. gonorrhoeae rencana respons kesehatan masyarakat cephalosporin tahan CDC s (14).