SU1491516A1 - Method of treating fresh acute and subacute uncomplicated forms - Google Patents

Abstract

The invention relates to venereology and relates to the treatment of acute and subacute uncomplicated forms of mixed gonorrheal-chlamydial infection of the urinary organs. The goal is a reduction in the duration of treatment. It is achieved by the fact that in the conventional complex of drugs, including doxycycline, the patient is additionally administered in pharmacopoeial dosage and regimen. In clinical trials, the high efficiency of the proposed method is shown, which reduces the treatment time to 8-10 days (compared to 12-15 days by the prototype method), prevents the occurrence of adverse effects of antibiotic therapy and reduces the incidence of complications from 20 to 3%.

Description

This invention relates to the field of medicine, namely venereology.

The purpose of the invention is to reduce the duration of treatment.

The method is carried out as follows.

A patient with fresh acute and subacute uncomplicated forms of mixed gonorrhea-chlamydial infection of the urinary organs simultaneously with doxycycline, is prescribed immediately 0.2 g (teaspoon) 3 times a day, while doxycycline is administered as follows: 0.3 g - the first intake, two subsequent intakes in 6 h and further in 12 h to 0.1 g, the course of treatment is 8-10 days.

The cumulative use of doxycycline and oraz reduces the treatment time for patients, while avoiding the occurrence of adverse events characteristic of long-term antibiotic therapy.

Example 1. Patient A. entered the dermatovenerologic dispensary with severe clinical manifestations of fresh acute TOTanbiforo urethritis: the sponges of the urethra are swollen, hyperpowered, and there is a large amount of purulent discharge from the urethra. From the anamnesis, it is clear that he fell ill after having sex with a woman eighteen days ago. Notes the increase in urination day and night.

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imperative urges, pain when urinating, especially at the end of urine in a two-glass test: the first and second urine portions are turbid, B cy-

The nuclei of the urethra are dominated by polysuclears, phagocytes, destructive cells, rare epithelial cells, Polynuclears 32-54-72 in the visual field (magnification x 400), Bacterioscopic IMC and bacteriological methods in Urethra urethra were identified, Neusser's gonococci were identified, In urethral material Identification (1 also chlamydia was cultured in L-929 cell culture. Chlamydia antigens in affected cells were detected by direct

immunofluorescence using polyclonal genus-specific chlamydial antibodies conjugated with ITC. As a result of the examination, the patient was diagnosed with a fresh, total total mixed gonorrhea chlamydial urethritis.

The treatment was carried out with doxycycline at the first dose of 0.3 g, followed by two doses of O, 1 g every 6 hours, then O, 1 g every 12 hours. The course duration is 7 days. The total dose of doxycycline 1.7 g. From the first day of treatment, the patient received one teaspoonful of granules (0.2 g) three times a day after meals for 9 days. Course dose orazy - 5.4 g

After the start of treatment on the third day, the bacterioscopic method of gonococcus was not identified, Chlamydia cytology, Pr No. 1m and mmu were not detected by the fluorescent and culture methods on the sixth day after the start of treatment,

On the second day after the start of the treatment, the patient noted the disappearance of the dispensary manifestations and the reduction of purulent discharge from the urethra.

The clinical inflammatory manifestations in the urethra were completely resolved on the sixth day after the start of treatment. Cytologically marked in the preparation was the predominance of epithelial cells, Polynuclears 5-12-14 in the visual field (magnification x 400), Yeast-like fungi were not identified.

After a combined provocation - instillation of the urethra with a 0.5% solution of silver nitrate and intracerebral injection of pyrogenal 100 MDC - gono

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cocci and chlamydia are not affected. Signs of the inflammatory process are not installed. The patient was discharged from the stadium for further follow-up monitoring on an outpatient basis for 2 months. Postgonoreal complications, including recurrence of the disease, did not occur during the observation period.

Example 2, Patient B, was admitted to the dermatovenerologic dispensary with the clinical manifestations of subacute urethritis and endocervic-a. Sick 1 month ago after having sex with a familiar man. Notes complaints of pokalya: in the urethra when urinating.

When the examination revealed: moderate swelling of the sponges of the urethra, muddy drops were obtained from the urethra during the massage. The posterior wall of the urethra is smooth. The mucous of the cervix is slightly hyperemic, moderate amounts of purulent secretions are expelled from the cervical canal, the uterus appendages on palpation without pathological changes,

In a material taken from the urethra and the cervical canal, Neisser's gonococci were identified by bacterioscopic and bacteriological methods, Chlamydia was identified by cytological and direct immunofluorescence methods using urethral scraping.

In the cytogram of the urethra epithelial cells dominate, many destructive cells, Polynuclears 23-28-34 in the field of view (increase 400 l), Microscopically a large number of destructive cells are detected in the preparation from the cervical canal, polynuclei 48-53-62 in the field of View (increase 400)

A diagnosis was made: fresh subacute mixed gonorrhea-chlamydia urethritis, endocervicitis.

The patient was prescribed doxycycline treatment at the first dose of 0.3 g, followed by two doses after 6 hours at 0.1 g, and then every 12 hours later. Treatment with doxycycline was continued with 8 days. A course dose - 1.9 g. From the first day of treatment, the patient received an oral dose of one teaspoon of gra-. zero (0.2 g) three times a day after meals for 10 days. Course dose Oraza 6.0 g

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After the start of treatment on the fourth day, the gonococci were not identified by the bacterioscopic method. Chlamydia by cytological, npHNbiM immunofluorescence method was not detected on the seventh day after the start of treatment.

Clinical manifestations of the inflammatory process resolved on the seventh day after the start of treatment, polynuclears in the material from the urethra 4-7-11 in the field of view (increase), epithelial cells dominate in the material from the cervical canal, polynuclears 8-12-13 in the field of view (increase AO), yeast fungi are not identified.

After a combined provocation — instillation of the urethra with a 1% silver nitrate solution, a 2% cervix treatment solution, and a 1-st of the pyrogenap 50 MPD — gonococcus and chlamydia were not detected. Signs of the inflammatory process are not manifested. The patient was discharged from the hospital for further follow-up in ambulatory conditions during two menstrual cycles. Postgonoreal complications, including

including and recurrence of the disease, did not occur during the observation period.

Thus, the proposed method of treating fresh acute and subacute uncomplicated forms of mixed gonorrhea

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no-chlamydial infection is highly effective and allows you to shorten the treatment time to 8-10 days (compared to 12-15 days according to a known method) and prevent the occurrence of complications and side effects of antibiotic therapy from 2-3%. The results are given in tadpitsa.

Claims (1)

Invention Formula The method of treatment of fresh acute and subacute undeclared forms of mixed gonorrhea-chlamydial infection of the urinary organs by administering a complex of medicines, including doxycycline, characterized in that, for the purpose of juice treatment, the patient is additionally given an oral dose in the pharmacopoeia of 1 dose and mode e