Treatment for gonorrhea

Diagnosis of gonorrhea (gonorrhea) is based on the analysis of the specific complaints of the patients, anamnesis of illness after casual sexual relationship and objective investigation of patients. During the inspection of the external opening of the urethra swollen, hyperemic, with pressure on the urethra from the outside of the hole appears greenish thick pus.
The main method of laboratory diagnosis of gonorrhea (gonorrhea) is bacterioscopic. Men exploring discharge urethra in women detachable urethra, cervix, and rectum. Before taking smear patients with gonorrhea should not urinate for 2-3 hours before a diagnosis can be assigned to them antibiotics and sulfa drugs because of the possibility of occurrence of atypical forms of gonococci, or their complete disappearance of discharge. Material for study take after washing of external genitals. Better to take a free draining pus sterile bacteriological loop, and from the cervical canal with the help of forceps or a long tweezers.
The resulting material is applied on 2 slides and smear them with a thin layer. One stroke paint 1% solution metilenovogo blue, second - gram. At colouring of 1% solution metilenovogo blue well identified eosinophils, the number of which in chronic gonorrhea increased, which serves as a diagnostic symptom. Microscopic examination of the drug, a gram-stained, is determined by the overwhelming number of multi-core leukocytes, separate epithelial cells, a large number of gonococci, located mainly inside of cells. The most characteristic features of gonococci are: form bean, intracellular location and gram-negative coloring.
Microbiological diagnosis is also important in the control of cure gonorrhea.
Treatment of acute uncomplicated gonorrhea (gonorrhea): treatment should be preceded by hygienic measures, to eliminate the possibility of complications. It is necessary to avoid physical activities, sports exercises; complete sexual abstinence, the elimination of sexual excitation.
Drug therapy. The most active antibiotics: penicillin intramuscular injection of 200 000 IU every four hours during two or three days, not less than 2 000-3 000 000 000 IU per course of treatment or economically 600 000 IU at intervals of 10 - 12 hours. Gonorrhea disappear in a day, inflammatory phenomenon in 4 to 7 days. Penicillin can be combined with streptomycin 0.25 2 times a day. Of antibiotics that is inside the body, it is recommended that the syntomycin 0,5 g per reception - up to 2.0 grams per day, a total of 6.0-8.0 g per course of treatment, terramycin and tetracycline 300 000 UNITS 5 times a day, up to 5 000 000 UNITS in acute gonorrhea and up to 8 000 000 IU for complicated gonorrhea.
From sulfa drugs recommended sulfadimezin or norsulfazol 1 g five times a day, up to 20 g per treatment course. When side effects treatment sulfa drugs should be stopped, appointing copious amounts of alkaline water and laxatives. Sulfa drugs contraindicated with cardiac decompensation, blood disease, nephrosis, and nephritis.
After 7 days at the end of treatment should control study patient for the establishment of cure. Conduct a thorough clinical examination, take swabs from the urethra and other lesions within 3 days. In the absence of a smear gonococci are provocation: give a sharp salty food, alcoholic beverages; men enter into the urethra 0.25% solution of nitrate of silver, women smeared with silver nitrate solution (0.25 per cent) of the lining of the urethra and cervix, intramuscularly a gonovaccine and re-examines the strokes.
After a month refresher control examination, including the taking of the strokes, the ureteroscopy. Gonorrhea after treatment leaves no immunity, possible re-infection.
In chronic gonorrhea antibiotics and sulfonamides early treatment is ineffective because of the inflammatory focus has reduced reactivity, and microbial factor has a decisive role in the inflammatory process. So these patients on prescription spend the first 5-6 intramuscular injection of monovaccine 200 million microbial bodies in 1-2 days.
Prevention should be aimed at preventing the spread of gonorrhea and consists of sanitary-educational work, the struggle for a healthy way of life, the identification of patients, which was a source of infection gonorrhea, and attracting them to treatment. Preventing gonorrhoea after casual sexual relationship are: the washing of external genitals with warm water and soap, introduction into the urethra and cervical channel cervix solution of protargol, douching with a solution of potassium permanganate.