EBM Nursing Assignment Sample on Evidence-Based Management of Gonorrhoea

Introduction – EBM Nursing Assignment Sample

Gonorrhoea caused by Neisseria gonorrhoeae continues as a major worldwide public health priority due to approximately 87 million yearly cases globally. The lack of proper treatment will lead to pelvic inflammatory disease and epididymitis as well as infertility and enhance the hazard of transmitting HIV (Henkel, 2020). Before deciding on a course of action, the British Association for Sexual Health and HIV suggests ceftriaxone and azithromycin for front-line therapy, but this current case requires different solutions because of reported allergies by the patient.

The clinical presentation from a patient, age 32, shows dysuria and purulent discharge from his urethra after two months of multiple partner unprotected intercourse. Alternative drug treatments need identification and evaluation due to the patient's documented allergies while looking for medications with alternative side effects (Ramsey et al., 2021). The patient's clinical management will benefit from both an antimicrobial stewardship initiative alongside patient education and partner notification methods.

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Management Options

Researchers propose combining gentamicin intramuscularly with oral doxycycline as an alternative treatment method. The treatment approach relies on gentamicin to prevent protein synthesis and doxycycline to block ribosomal function. Medical investigations show high elimination rates when treating simple gonorrhoea complications (Cao et al., 2023). The medical outcomes from using gentamicin include kidney-induced toxic reactions and hearing loss yet doxycycline could trigger skin reactions along with digestive system problems. Administering gentamicin by injection provides an effective treatment method even though discomfort makes patients less likely to select this option.

A combined therapy of cefixime and fosfomycin administered orally represents another pharmacological treatment for gonorrhoea (Angelo Roberto Raccagni et al., 2023). The antibiotic cefixime functions to halt the cell wall development of bacteria but interferes with fosfomycin's mechanisms that disrupt peptidoglycan construction inside bacteria. Research shows that a combination of medications is effective at treating gonorrhoea. While taking Cefixime, patients commonly experience diarrhoea along with abdominal cramps but those who use fosfomycin may find headaches paired with nausea. These treatment components create an entirely oral regimen, which increases patient compliance.

The new macrolide antibiotic solithromycin represents a third treatment choice because it exceeds the bactericidal capabilities of azithromycin. Research indicates solithromycin delivers initial positive results, yet it cannot be accessed through widespread approval channels. When taken, liver enzymes can elevate, and patients may experience gastrointestinal distress. The medication acts as a critical backup therapy for patients whose alternative treatments prove unresponsive.

The non-medicine medical strategy incorporates informing partners about diseases and providing STI prevention education (Jessop and Peisah, 2021). The digital tracing method operated through health platforms enables users to receive secure partner notifications. Behavioural prevention programs designed to educate patients about safe sex methods and distribute condoms effectively reduce individuals' risk of STI reinfection while boosting STI prevention capability (Jessop and Peisah, 2021). The effectiveness of both approaches may face challenges from difficulties with partner engagement and stigma-related barriers.

Gonorrhoea has been treated with recent advancements beyond conventional antibiotic therapy. Azithromycin and ceftriaxone are two promising pharmacological options. Macrolide antibiotic azithromycin and ceftriaxone, a cephalosporin, interfere with bacterial protein synthesis and kill the bacteria by attacking bacterial cell walls (Allen and Morrill, 2023). However, clinical trials show that the combination of these two drugs lowers the risk of treatment failure to over 90%. However, although sometimes mild or moderate side effects are experienced, including gastrointestinal upset, skin rash, and headache, no severe side effects are known to occur (Saïd Abdellati et al., 2024). These treatments are typically administered as a single dosage regimen, increasing patient compliance. However, because of their high effectiveness, the emergence of drug-resistant strains particularly applies to Neisseria gonorrhoeae that have developed azithromycin resistance (Saïd Abdellati et al., 2024). The result has been health authorities' advice to employ a combination approach, reducing the risk of resistance and covering all risks of treatment.

Another option of pharmacological treatment is the combination of cefixime with gentamicin. Oral third-generation cephalosporin, cefixime, inhibits bacterial cell wall synthesis, while aminoglycoside, gentamicin, disturbs bacterial protein synthesis. This combination is highly effective against gonorrhoea, and cure rates are more excellent than 95% in uncomplicated cases (Arumugham, Cascella and Gujarathi, 2020). Gentamicin can be injected because the bactericidal activity is quicker and more reliable, while cefixime is easier orally. The leading lousy aspect of gentamicin is that it includes nephrotoxic and ototoxic potential, causing kidney and hearing problems with the usage of it being prolonged. This therapy is most often used on an intermittent schedule patients must be carefully followed to avoid these severe side effects (Ogier, Lockhart and Burt, 2019). This, however, combination is still a good choice in cases of severe or gonorrhoea-resistant cases in which first-line treatments fail.

A third pharmacological alternative that is receiving increasing interest is pristinamycin, a streptogramin antibiotic, where gonorrhoea is increasingly becoming resistant to traditional treatments (Oriol Mitjà et al., 2023). Pristinamycin interferes with bacterial protein synthesis in two distinct ways and is effective against numerous, especially Gram-positive and some Gram-negative organisms. As per the view of Read et al. (2018), Pristinamycin alone or in combination with other antibiotics, such as ceftriaxone, show a high cure rate of up to 98% in cases of gonorrhoea. However, the use of the is limited as no widespread approval is available yet. Mild GI disturbances, including nausea and diarrhoea, may occur, and these symptoms are transient and resolved upon discontinuation. As a treatment for multidrug-resistant gonorrhoea, it is of great medical importance.

There are also essential non-pharmacological strategies to manage gonorrhoea transmission. It is critical to reducing the spread of gonorrhoea that educational programs are aimed at increasing people’s awareness and understanding of practising safe sex, such as using condoms (Inthavong et al., 2020). These programs, delivered through community health organizations and clinics, make people aware that regular screening and prevention are essential. Studies of comprehensive education have shown around a 30% reduction in gonorrhoea in high-risk populations, such as sexually active young adults and men who have sex with men (Kirkcaldy et al., 2019). Innovative ways to monitor sexual health and send automated reminders to partners to be tested and treated are available in digital health interventions (mobile apps, for example), in addition to improving physical contraception itself (for example, FocalBands, a contraceptive band application). In particular, these are very useful in urban areas, where people are more likely to use technology for health reasons. Addressing these issues will continue to be necessary for long-term reductions in gonorrhoea rates through outreach and community involvement.

Critical Evaluation of the Evidence

Treatment selection approaches an appropriate equilibrium between maximum outcome efficiency, minimum risks, and individual patient circumstances. Treatment success rates are high with Gentamicin and doxycycline, yet patients need consistent nephrotoxicity monitoring. Although resistant strains pose concerns, combining cefixime and fosfomycin offers an appealing oral treatment option (Franco and Hammerschlag, 2024). As an emerging treatment, solithromycin shows promise to expand therapeutic options but lacks the necessary clinical validation at this time. Traditional patient identifier strategies work as foundational components in managing STIs. Digital partner tracing systems increase notification success rates, leading to prompt medical care while lowering potential spread risks.

There are also essential non-pharmacological strategies to manage gonorrhoea transmission. It is critical to reducing the spread of gonorrhoea that educational programs are aimed at increasing people’s awareness and understanding to practice safe sex, such as using condoms. These programs, delivered through community health organizations and clinics, make people aware that regular screening and prevention are essential. Studies of comprehensive education have shown around a 30% reduction in gonorrhoea in high-risk populations, such as sexually active young adults and men who have sex with men (Shannon and Klausner, 2019). Other digital health interventions like in Mobihealthnews include mobile apps and web-based platforms that can help track sexual health and cue partners to get tested and, if necessary, treated through automatic notifications. Particularly in urban contexts, where people tend to interact with tech for health, these tools have been particularly effective. Addressing these issues will continue to be necessary for long-term reductions in gonorrhoea rates through outreach and community involvement.

The combination of cefixime with fosfomycin offers promise as a treatment for STIs because it addresses antibiotic resistance issues that commonly affect Chlamydia trachomatis and Neisseria gonorrhoeae pathogens. Oral treatment with the antibiotic combination of cefixime and Fosfomycin demonstrates high effectiveness because both medications belong to different antibiotic groups (Seok et al., 2020). Angelo Roberto Raccagni et al. (2023) have stated that, the use of cefixime and Fosfomycin together to combat gonorrhoea resistance in particular strains of the infection because traditional penicillin and tetracycline antibiotics have become less effective. The medical combination provided 95% success rates for treating gonorrhoea in male patients when administered in outpatient care environments (Yang et al., 2022). Patients choose oral antibiotics as their preferred medication because these drugs eliminate both the requirement of hospital attendance and the need for injections.

The discovery of roxithromycin brings the most promising developments in STI treatment possibilities. The macrolide antibiotic presents strong potential in resisting antibiotic resistance challenges. The efficacy of solithromycin against Chlamydia and Gonorrhea infections is established yet further clinical examinations are required to declare full validation (Zhong et al., 2024). The antibiotic solithromycin is an innovative alternative against STIs showing resistance because macrolide antibiotics like azithromycin have become less effective within numerous geographical regions. Clinical professionals anticipate the completion of solithromycin trials because it may provide additional treatment choices for patients who do not respond to first-line prescriptions.

Digital partner notification systems and other non-pharmacological methods have substantially enhanced the management of STIs. Healthcare providers use these systems to conduct contact tracing operations more effectively, which raises the speed of transmitting STI exposure alerts to sexual partners (Kachur et al., 2018). Several studies have shown that relying on patients to reach their partners yielded success rates under 50%. Digital partner tracing has achieved considerable success in notification delivery since studies report notification success reaching approximately 80% (Woodward et al., 2024). Digital partner tracing remains highly successful at notifying individuals in areas with high STI cases because it prevents further transmission. Technology-based tracing systems create more significant support among patients because they provide anonymous and non-stigmatizing methods to alert partners and seek necessary treatment. Digital systems enable patients to get medical consultations immediately, lowering the risk of spreading infection.

The comprehensive tactic for managing STIs joins pharmaceutical medicines with non-drug treatments. Combining effective medication treatments like cefixime, Fosfomycin, and solithromycin with improved digital partner notification platforms will give healthcare providers a better system to handle STIs that is efficient, safe and accessible to patients (Yang, Yan and van der Veen, 2020). Supervision must continue to detect pharmacological side effects and evaluate treatment effects to maintain public health benefits while protecting individual patient safety.

Proper STI management practices involve mixing proven pharmaceutical medication treatments with fresh non-medicine therapeutic approaches. Antibiotics Gentamicin and doxycycline, cefixime, and Fosfomycin effectively treat common STIs, yet their clinical use requires ongoing assessment for adverse effects involving kidney damage and gastrointestinal complications (Workowski, 2021). Research into solithromycin shows promising data regarding its ability to address antibiotic resistance, but additional clinical proof is essential. The success rates for STI management multiply through digital partner notification systems and pharmacological interventions to offer discreet contact tracing services.

Conclusion

Preventing gonorrhoea requires an all-inclusive plan that combines both proper antibiotics in combination with treatment methods unrelated to the medication. Gentamicin combined with doxycycline and cefixime linked with Fosfomycin proves effective against gonorrhoea. Still, healthcare providers must track these treatments because they can lead to nephrotoxicity in addition to gastrointestinal symptoms. Scientists are testing solithromycin as a promising novel treatment option against resistant gonorrhoea, although it needs additional clinical testing for approval. Digital partner notification systems as non-pharmacological approaches maximize the effectiveness of contact tracing operations and decrease transmission levels through quick, discreet information delivery to sexual partners. Medical providers who integrate these treatment approaches obtain their best results in gonorrheal treatment while protecting patient safety and public health effectiveness. The reduction of gonorrhoea's worldwide impact requires active research efforts to improve STI management between two core fields: pharmacological treatments and digital health solutions.

References

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