Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0152447 (urethral discharge)
 296 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The current pattern of antibiotic use by drug store personnel in Bangkok was examined. Ten well-trained medical students (simulated patients) presented to 40 randomly selected drug stores with common complaints, namely urethral discharge, acute watery diarrhoea, fever with sore throat, coryza, skin infection and acute dysuria. Analysis of medications obtained revealed that 50-100% of drug stores dispensed antibiotics for each condition. Co-trimoxazole, ampicillin, chloramphenicol, penicillin V and tetracycline were commonly given. Most antibiotics were dispensed inappropriately with respect to choice of drug and duration of treatment. The cost per treatment varied from 20 cents to 6 $US. Strategies to promote rational use are proposed.
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PMID:Antibiotic dispensing by drug store personnel in Bangkok, Thailand. 335 19

Physicians treated a 37 year old man, who 5 years earlier had a successful vasectomy reversal, with a 24 hour history of intense left testicular pain, rigors, and pain and difficulty in urinating. Prior to these symptoms, he noted a mild, transient urethral discharge. Upon examination, physicians noted a fever of 38.5 degrees Celsius and swelling and tenderness around the left testis extending towards the groin. Pus cells existed in the urine, but no organism was found. While operating on the scrotal sac, physicians observed severe epididymitis which extended to the vasovasostomy site where a firm granuloma existed. The testis itself seemed fine. Blood cultures taken on admission revealed Haemophilus influenzae (non capsulate, biotype II) and ampicillin was administered intravenously. This case's physicians have not heard of any previous reported severe infection of a vasovasostomy site with bacteremia. Generally, granuloma formation after a vasovasostomy is caused by sperm leakage and represents an inflammatory response often resulting in obstruction. This may predispose the site to infection. Haemophilus influenzae rarely causes epididymo-vasitis but perhaps non capsulated strains possess an increased ability to evade host defenses, especially in a vasovasostomy granuloma, a damaged tissue.
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PMID:Epididymo-vasitis associated with previous reversal of sterilisation. 340 94

To determine the most effective, economical therapy for gonorrhea in Uganda, 5 single-session penicillin schedules were compared in a group of 460 university students with urethral discharge. A total of 590 episodes of gonococcal urethritis were treated. Patients were randomly allocated to 1 of 5 schedules. Treatment schedules and cure rates were as follows: 1) aqueous procaine penicillin 2.4 m.u. (125 cases), 90.3%; 2) procaine penicillin 2.4 m.u. plus ampicillin 1 gm (143 cases), 97.1%; 3) procaine penicillin 3 m.u. (90 cases), 89.8%; 4) procaine penicillin 3 m.u. plus probenecid 1 gm (103 cases), 97.1%; and 5) probenecid 1 gm orally followed by benzyl penicillin 5 m.u. (129 cases), 96.8%. 30 of the 31 treatment failures were successfully treated with an alternate schedule. The results obtained with procaine penicillin alone are considered unfavorable. Although highly effective, the probenecid and benzyl penicillin regimen is expensive and requires the preparation of penicillin with lignocaine solution and an extra 30-minute wait, making it inappropriate for Uganda's busy multipurpose clinics. The procaine-ampicillin combination was also highly effective, but its high cost limits it use to private practice. The 3rd highly effective schedule, the combination of procaine penicillin and probenecid, appears to most closely approximate the ideal single-session penicillin schedule for treatment of gonorrhea in Uganda. It is both inexpensive and easily administered. Moreover, the prolonged penicillinemia achieved by 3 m.u. procaine penicillin may be more effective in eliminating cases of incubating syphilis than benzyl penicillin. Long-acting procaine penicillin in oil with aluminum monostearate (PAM), which is the most widely used treatment regimen in the rural medical units of Uganda, is no longer indicated and may, in fact, be encouraging the spread of less sensitive strains of gonorrhea. Any change toward a more effective treatment schedule must, however, be accompanied by improvement in the diagnostic and treatment facilities in the country.
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PMID:In search of an ideal single-session penicillin schedule for the treatment of gonorrhoea in Uganda. 474 9

Strains of Neisseria gonorrhoeae requiring arginine, hypoxanthine, and uracil (Arg-Hyx-Ura-) are highly susceptible to penicillin G, and have been associated with asymptomatic urethral infection and disseminated gonococcal infection (DGI). The authors recovered Arg-Hyx-Ura- strains from 48% of 282 heterosexual men and women, versus only 9% of 69 homosexual or bisexual men (P less than 0.0001). In a separate population of consecutive men with urethral gonococcal infections, urethral discharge was absent in 0 of 96 homosexual men, versus 18 of 261 heterosexual men (P less than 0.025). Homosexual men accounted for none of 41 cases of DGI in men in 1970--1973, compared with 35% of men with uncomplicated gonorrhea in 1978. These findings suggest that asymptomatic urethral gonococcal infection and DGI are uncommon in homosexual men, perhaps because infection with Arg-Hyx-Ura- strains is relatively uncommon. Screening cultures of urethral specimens for N. gonorrhoeae had a low yield among homosexual men in the population studied. Strains of N. gonorrhoeae recovered from homosexual men were significantly more resistant to penicillin than were isolates from heterosexual subjects; this was true even for non-Arg-Hyx-Ura-strains. This difference may help to explain the lesser efficacy of ampicillin in treatment of rectal gonococcal infection in homosexual men.
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PMID:Correlation of auxotype and penicillin susceptibility of Neisseria gonorrhoeae with sexual preference and clinical manifestations of gonorrhea. 677 77

A case of gonococcal urethritis with bilateral tysonitis and periurethral abscess is described. The diagnosis of gonococcal urethritis was made by microscopic detection of typical gram-negative intracellular diplococci in cells of the urethral discharge. The patient was treated with oral ampicillin and probenecid for ten days together with oral oxytetracycline for seven days; he responded favorably to antibiotics, and surgical intervention was unnecessary.
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PMID:Gonococcal urethritis with bilateral tysonitis and periurethral abscess. 678 67

Between November 1992 and April 1993, interviews were conducted with 400 patients (169 men, 231 women) aged 14-52 years at the sexually transmitted disease (STD) clinic of the Institut d'Hygiene Sociale in Antananarivo, Madagascar, to determine the pattern of STDs and to improve treatment of the leading STDs. The 400 patients presented with 434 syndromes. 124 men had urethral discharge. 210 women had cervicovaginal discharge. 43 men and 18 women had genital ulcers. Clinicians could not establish a diagnosis in 33 patients. 171 patients had more than one infection. Chlamydia infection was the most common infection associated with another STD (gonorrhea in 22% of men and 11% of women with discharge, trichomoniasis in 2.4% of men and 13% of women, candidiasis in 1.6% of men and 9% of women, and bacterial vaginosis in 15% of women with discharge). Gonorrhea was the most common etiology for male discharge (69%) while chlamydia infection was for female discharge (52%). Women with discharge were more likely than men with discharge to have chlamydia infection (52% vs. 42%), trichomoniasis (30% vs. 9%; p 0.00001), and candidiasis (32% vs. 12%; p 0.00001). 37% of women with discharge had bacterial vaginosis. Chlamydia infection was the most common STD in this population (45%). 32% of male and 71% of female gonorrhea cases also had chlamydia infection. 70 patients had syphilis. 36 of them had secondary stage syphilis. No one had HIV-1 or HIV-2 infection. The most efficacious antibiotics for gonorrhea were ampicillin, ciprofloxacin, and spectinomycin (100% susceptibility). 31% and 26% of isolates were susceptible to tetracycline and cotrimoxazole, respectively. Public facilities in Madagascar do not have the capabilities to diagnosis chlamydia, resulting in many untreated chlamydia cases. These findings stress the need to improve combined treatment of gonorrhea and chlamydia infection and for educational efforts to increase awareness of genital ulcer disease.
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PMID:Pattern of sexually transmitted diseases in a Malagasy population. 787 44

Sixty eight Neisseria gonorrhoeae strains were isolated from endocervical and urethral discharge of 233 patients attending health centres for sexually transmitted diseases (STDs) in Addis Ababa, were identified following conventional procedures and tested for susceptibility to penicillin, ampicillin, trimethoprim-sulphamethoxazole (bactrim), chloramphenicol, erythromycin and kanamycin by the agar disc diffusion technique. Penicillinase producing N. gonorrhoeae (PPNG) were identified using the chromogenic cephalosporin method and comprised 70% of the isolates. Seventy seven per cent, 73%, 64% and 17% of the isolates were found to be resistant to penicillin, ampicillin, bactrim and kanamycin, respectively. However, no resistance to erythromycin and chloramphenicol was observed. Multiple drug resistance was found to be 67%. This is a cause for concern in the control and treatment of gonococci.
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PMID:Drug susceptibility of Neisseria isolates from patients attending clinics for sexually transmitted diseases in Addis Ababa. 949 Nov 82

STDs are a significant public health problem in Brazil. A primary control strategy is the immediate treatment of symptomatic individuals. When services are unavailable, STD patients seek care in alternative settings. Probably the most frequently used settings are commercial pharmacies, where pharmacy clerks provide treatment, although Brazilian law prohibits selling antibiotics without prescription. Our objective was to evaluate prescribing practices by pharmacy clerks for STDs. We performed a cross-sectional study. Trained medical students visited 62 pharmacies in the city of Porto Alegre during March 2002. These were randomly chosen from a list of 863 registered pharmacies. The students presented to the pharmacy complaining of dysuria and urethral discharge. After obtaining a prescription, or not, they asked for additional instructions to be followed. Immediately after leaving the premises, the instructions were anonymously recorded. Of the 62 pharmacies visited, a clerk in 56 (90.3%, 95% confidence interval [CI]: 80.1%-96.4%) provided a prescription. Most frequently prescribed drugs were ampicillin with probenecide (29/51.8%) and rosoxacin (11/19.6%). Ministry of Health-recommended treatment was not suggested by any of the clerks. Forty-six additional recommendations were given. The use of condoms was the most frequent additional advice (42/46). Prescribing by pharmacy clerks is very prevalent in Porto Alegre. This may represent a lost opportunity for more comprehensive prevention effort (counselling, partner management, and diagnosing other STDs). Additionally, the most frequently prescribed drugs are not recommended by international or national health authorities for treatment of STDs, and none of these drugs covers chlamydia. We conclude that pharmacy clerks are a potentially important source of STD treatment and control but that their practices are in need of vast improvement.
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PMID:Pharmacy clerks' prescribing practices for STD patients in Porto Alegre, Brazil: missed opportunities for improving STD control. 1511 4