The antibiotic management of gonorrhoea in Ontario, Canada following multiple changes in guidelines: an interrupted time-series analysis.

Objective: This study assessed adherence with first-line gonorrhoea treatment recommendations in Ontario, Canada, following recent guideline changes due to antibiotic resistance.

Methods: We used interrupted times-series analyses to analyse treatment data for cases of uncomplicated gonorrhoea reported in Ontario, Canada, between January 2006 and May 2014. We assessed adherence with first-line treatment according to the guidelines in place at the time and the use of specific antibiotics over time.

A systematic review and appraisal of the quality of practice guidelines for the management of infections.

Background: Clinical guidelines help ensure consistent care informed by current evidence. As shifts in antimicrobial resistance continue to influence first-line treatment, up-to-date guidelines are important for preventing treatment failure. A guideline's development process will influence its recommendations and users' trust.

Approach to lymphogranuloma venereum.

Objective: To review the literature about lymphogranuloma venereum (LGV) and to provide an overview and discussion of practice guidelines.

Sources Of Information: The terms Chlamydia trachomatis and lymphogranuloma venereum were searched separately in PubMed. Empirical studies, practice reviews, and clinical guidelines were included.

"Express testing" in STI clinics: extant literature and preliminary implementation data.

In an era of stagnant resources for sexually transmitted infection (STI) and HIV testing clinics, and at a time of ongoing-and in some cases increasing-STI and HIV transmission, it is important to trial and evaluate novel STI/HIV testing strategies. Based on the extant literature, one such approach is express testing, which includes full STI/HIV testing (as per clinical indication and client request), altered pretest counseling, and no physical examination for both men and women. In this paper, we overview the available research about express testing, including the literature on less-invasive testing, the effects of risk reduction counseling HIV testin/HIV testing, available research on various HIV testing modalities, and the reasons people undergo such testing.

Gonorrhea Treatment Failures With Oral and Injectable Expanded Spectrum Cephalosporin Monotherapy vs Dual Therapy at 4 Canadian Sexually Transmitted Infection Clinics, 2010-2013.

Background: Antimicrobial resistance has developed to all antibiotics used to treat gonorrhea (GC), and trends in GC antimicrobial resistance have prompted changes in treatment guidelines. We examined treatment failures in sexually transmitted infection clinics.

Methods: Four Canadian sexually transmitted infection clinics reviewed treatment regimens, minimum inhibitory concentrations for cephalosporins and azithromycin, anatomical infection sites, and treatment outcomes for GC infections between January 2010 and September 2013, in individuals who returned for test of cure within 30 days of treatment.