Prescribe antibiotics to men with uncomplicated gonococcal urethritis

The development of antibiotic resistance in Neisseria gonorrhoeae contributes to major problems concerning the management of each patient suffering from gonorrhea. Observational studies on the epidemiology of gonococcal infection in France revealed an increase in the frequency of gonorrhea in 2006. Due to the development of resistance in N. gonorrhoeae for antimicrobial agents fluoroquinolones from this group have been excluded as a treatment standard from the French national guidelines for the treatment of gonococcal infection. Ceftriaxone, along with the concomitant administration of azithromycin to block infection caused by Clamydia trachomatis, are among the recommended medications.

The objective of the pharmacoepidemiological study carried out in France was to study management tactics (namely the setting up of antibiotic therapy) for men with symptoms indicating acute uncomplicated urethritis.

During the study, a special form of the questionnaire was developed, containing a brief description of the typical symptoms of gonococcal urethritis in a man and questions about the choice of antibiotic therapy. This questionnaire was sent by email to 1,000 randomly selected French general practitioners.

At the end of the survey, 350 completed questionnaires were returned to the researchers (ie, the response rate was 35%). Only one fifth (66 doctors, 20.2%) prescribed the antibiotics recommended for the simultaneous treatment of infections caused by N. gonorrhoeae and C. trachomatis, while 132 doctors (40.4%) indicated only the recommended antibiotics, including ciprofloxacin, which was prescribed in 69 cases (21.1%). Doctors who have been practicing medicine for less than 10 years were more attached to practical recommendations than doctors whose practice had continued at the time of the survey for more than 10 years (p less than 0.05).

Thus, the results obtained indicate that there is a divergence between the practical recommendations available and the real tactics of prescribing antibiotics to men suffering from uncomplicated urethritis by French general practitioners, and the errors were mainly encountered by doctors. who have been practicing for longer (i.e. more than 10 years). Particular attention should be paid to educational activities to improve the management of patients with acute urethritis in clinical practice.