Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chancroid is linked to the spread of human immunodeficiency virus type 1 (HIV-1) in East Africa. Effective, easily administered therapy is a priority for the control of Haemophilus ducreyi. The efficacy of a single oral dose of fleroxacin, 400 mg, was compared to a 3-day oral course of trimethoprim-sulfamethoxazole (TMP-SMZ), 160/800 mg, twice daily for the treatment of chancroid in 98 HIV-1-seronegative men in Nairobi, Kenya. No differences were noted between the two groups with respect to demographic characteristics, sexual behavior, and clinical characteristics. Culture-proven failure occurred in 1 (3%) of 36 fleroxacin-treated patients and in 11 (30%) of 37 TMP-SMZ-treated patients (P = .005). Fleroxacin, as a single oral dose, is an effective treatment for culture-proven chancroid in patients who are HIV-1 seronegative. TMP-SMZ is no longer predictably effective due to the recent emergence of resistance to both sulfonamides and to trimethoprim.
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PMID:A randomized, double-blind study of the efficacy of fleroxacin versus trimethoprim-sulfamethoxazole in men with culture-proven chancroid. 156 47

Since the 1989 Sexually Transmitted Diseases Treatment Guidelines were published by the Centers for Disease Control and Prevention, changes in the efficacy of the recommended and alternative regimens for the treatment of Haemophilus ducreyi infections have been described. Among recommended agents, erythromycin remains effective, and although a single dose of ceftriaxone appears to remain effective in the United States, limited data from Kenya have shown that this regimen has been associated with treatment failures. Of alternative treatment regimens, trimethoprim-sulfamethoxazole has been associated with widespread failure, but little work has been done to further evaluate the efficacy of the amoxicillin/clavulanic acid and ciprofloxacin regimens. Of the new antimicrobials, azithromycin has been very effective in the United States, but the efficacy of this drug elsewhere has not been thoroughly evaluated. Fleroxacin has been very effective in Kenya. Data from Africa indicate that patients who are infected with the human immunodeficiency virus do not respond to therapy as well as patients who are not, and patients who are uncircumcised may not respond as well to therapy as do patients who are circumcised.
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PMID:Recommendations for treatment of chancroid, 1993. 779 8