COST-EFFECTIVE TREATMENT OF UNCOMPLICATED GONORRHEA INCLUDING COINFECTION WITH CHLAMYDIA-TRACHOMATIS

We evaluated the cost effectiveness of treating uncomplicated gonorrho ea in a theoretical cohort of 1000 adults (nonpregnant women of reprod uctive age, or men) with either intramuscular ceftriaxone 125mg or a s ingle oral dose of cefixime 400mg, ofloxacin 400mg or ciprofloxacin 50 0mg. We assumed that all patients were also empirically treated for un complicated chlamydial infection, with either a single oral dose of az ithromycin 1g, or oral doxycycline 100mg twice daily for 7 days. Treat ment of gonorrhoea with intramuscular ceftriaxone was found to be the most cost-effective alternative. This was followed by treatment with t he either of the fluoroquinolones (ofloxacin or ciprofloxacin), then c efixime. For empirical treatment of uncomplicated chlamydial infection , doxycycline was more cost effective than azithromycin when approxima tely more than 80% of the patients were assumed to comply with the dox ycycline regimen. When patients' compliance was poor with the doxycycl ine regimen, the azithromycin therapy became more cost effective from a societal viewpoint. Nevertheless, its relatively high cost to the in dividual patient with limited financial resources might prevent him or her from filling prescriptions. Any decrease in patients' compliance with the azithromycin therapy would favour treatment with doxycycline.