![]() The recommended treatment which covers N. 5īroad-spectrum treatment is justified in pelvic inflammatory disease (PID) because the consequences of untreated Resistance is becoming increasingly common, with a prevalence of approximately 30% across New Zealand, varying by location. Azithromycin (oral) is also routinely given when treating gonorrhoea, because co-infection with chlamydiaĬiprofloxacin (500 g stat) is an alternative to ceftriaxone if cephalosporins are contraindicated (most often due toĪ documented allergy to beta-lactam antibiotics) or if the isolate is known to be sensitive to ciprofloxacin.Ciprofloxacin 4 Therefore a repeat test to ensure cure is not usually required as long as the patient is asymptomaticĪfter treatment. 3 Standard treatment with ceftriaxone has been shown to be greater thanĩ5% effective. Research shows that ceftriaxone attains the optimal concentrations to prevent the development of step-wise mutationsĪnd resistance in Neisseria gonorrhoea. ![]() N.B.Ĭeftriaxone is subsidised if prescribed for the treatment of confirmed ciprofloxacin-resistant gonorrhoea, and the prescription For more information on this and other conditions treated with cephalosporins, see the latest edition of our handbook, "Antibiotics: Choices for common infections", bpac nz.įirst line indications for cephalosporinsĪ single dose of ceftriaxone 250 mg given intramuscularly is the treatment of choice for gonorrhoea. Norfloxacin is now used in place of cephalexin for third-line treatment of UTIs in pregnancy Ĭephalexin is also now recommended in place of cefaclor. Mastitis – first-line flucloxacillin, second-line erythromycin or cefaclorįirst-line nitrofurantoin, second-line trimethoprim, third-line cephalexin ![]() Meningitis – ceftriaxone is an alternative to benzylpenicillinĬellulitis – first-line flucloxacillin, second-line erythromycin, roxithromycin, co-trimoxazole or cefaclorĭiabetic foot infections – first-line amoxicillin clavulanate, second-line co-trimoxazole or cefaclor in combination Sinusitis – first-line amoxicillin, second-line doxycycline, co-trimoxazole or cefaclor Otitis media – first-line amoxicillin, second-line erythromycin, co-trimoxazole or cefaclor Pelvic inflammatory disease – ceftriaxone in combination with doxycycline and metronidazoleĮpididymo-orchitis – ceftriaxone in combination with doxycycline Gonorrhoea – ceftriaxone in combination with azithromycin Table 1: First and second-line indications for cephalosporins Ceftriaxone is also appropriate empiric treatment for suspected meningitis (if sexually transmitted pathogens are suspected). Ceftriaxone may be usedįirst-line for some genital tract infections such as gonorrhoea, pelvic inflammatory disease (PID) and epididymo-orchitis There are few infections where cephalosporins are the antibiotics of first choice (Table 1). They are also very active against streptococci. ![]() Of cephalosporins and are active against Gram-negative organisms, including many of the significant Enterobacteriaceae. They have the widest spectrum of activity compared to other generations
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