GC Flashcards
Incubation for GC
2-5 days
Cervical infection: most common sx and rare sx
Common discharge
Rare-Imb/menorrhagia. Sometimes contact bleeding
Lower abdo pain rare unless C4 infection too
Pharynx sx GC
Rarely any, sometimes sore throat
Rectal GC sx common and rare
Common- none
Sometimes d/c or pain
NAAT sensitivity for GC whether symp or not
> 95%
If woman had hysterectomy, where should you take a NAAT for GC?
Urine or VVS
When should you take a pharynx NAAT regardless of sexuality or gender?
If they have acquired GC from Asia Pacific region or has cef resistant GC
What are the 3 scenarios when you should take GC cultures?
Before Rx for GC
When you suspect GC at the time of NAAT
Or contact of GC
-Treatment for GC? — if sensitivity not known —if sens known —Pen allergic? —Declines injection
-other advice?
Unknown sens: 1g cef Im
Sens to cirpro: give cipro 500mg po stat
Pen allergy: all but a few first generation cephalosporins are ok (don’t use cephalon, cefaclor, cefadroxil), but you can use cefixime and ceftriaxome (3rd Feb) unless there has been genuine anaphylaxis to any beta lactams (pen, cefs, carbapenems)
Any alternative regimes below should be given 2g azitrho as well: Cefixime 400mg PO stat Gent 240mg IM stat Spectinomycin 2g IM star Or just azithro 2g stat
Abstain for 7d after rx
Urine vs urethral NAAT? How do their sensitivities compare?
Same, so FPU preferable
What % of people with GC also have c4?
19%
What is the prev of cipro resistance to GC?
And when should it be used?
Who should it be used in caution with?
36% so only use if sensitivity proven at all sites of infection (could have different GC at each site)
-Use with caution if over 60, taking steroids, kidney disease or it had organ transplant
What is the reason for increasing the cef dose for GC rx?
High levels of cef and azithro resistance (MIC>0.125) means that although most could be rx with 500mg, 1g would be more helpful in those with very high MIC levels
Treatment of GC complicated by PID or EO?
Or GC conjunctivitis
Or disseminated GC?
Pid: cef plus regime for pid
EO: cef plus regime for EO
Conjunctivitis- 1g cef only
Disseminated: cef 1g every 24hrs, for 7 days but switched to oral 1-2 days after sx improve, such as cefixime 400mg BD
In pregnancy/BFing
Treatment of GC:
What to avoid?
What to give?
Avoid tetracyclines or quinolones
Pregnancy doesn’t diminish rx efficacy.
Give usual ceftriaxone
Or spectinomycin 2g IM stat (use with caution if bf)
Azithro 2g stat if known susceptible.
