Qué tratamiento empírico es el más adecuado en pacientes con uretritis

espanolObjetivo. Conocer el tratamiento empirico mas adecuado de uretritis, en pacientes de la zona Centro de Madrid. Metodos. Se analizo el exudado uretral de 2.021 hombres entre Enero 2003-Diciembre 2007. Ademas de los cultivos tradicionales se determino la presencia de Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis y Herpes simplex. La sensibilidad de Neisseria gonorrhoeae y Haemophilus spp. se realizo mediante el metodo de difusion en disco y la sensibilidad de U. urealyticum mediante Micoplasma IST2. Resultados. El porcentaje de muestras positivas fue de 30,6%. Los microorganismos aislados mas frecuentemente fueron: U. urealyticum 9,9%, N. gonorrhoeae 7,4%, C. trachomatis 5,1% y Haemophilus spp 3,8%. La resistencia de N. gonorrhoeae en el primer periodo fue: penicilina 11,8%, tetraciclina 5,9%, ciprofloxacino 8,8% y presencia de betalactamasas 11,8%. En el segundo periodo: penicilina 9,7%, amoxicilina/acido clavulanico 1,4%, tetraciclina 8,3%, ciprofloxacino 23,6% y presencia de betalactamasas 10,5%. La resistencia a ciprofloxacino en no HSH (hombres que tienen relaciones sexuales con hombres) 20% y en HSH 56,2% (p Conclusiones. N. gonorrhoeae presento mayor resistencia a tetraciclina y ciprofloxacino en el segundo periodo, siendo estadisticamente significativo para ciprofloxacino (p EnglishObjective. To know the best empirical treatment of urethritis in patients at the City Center of Madrid. Methods. 2.021 urethral exudates were analyzed in men between January 2003-December 2007. In addition to the traditional cultures, it was determined the presence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis and Herpes simplex. The susceptibility of N.gonorrhoeae and Haemophilus spp was performed by disk diffusion method and U. urealyticum by Mycoplasma IST. Results. The percentage of positive samples was: 30.6%. The most frequently isolated microorganisms were: U. urealyticum 9.9%, N. gonorrhoeae 7.4%, C. trachomatis 5.1% and Haemophilus spp 3.8%. The resistance of N. gonorrhoeae in the first period was: penicillin 11.8%, tetracycline 5.9%, ciprofloxacin 8.8% and presence of betalactamase 11.8%. In the second period: penicillin 9.7%, amoxicillin/clavulanic acid 1.4%, tetracycline 8.3%, ciprofloxacin 23.6% and presence of betalactamase 10.5%. Resistance to ciprofloxacin in non-MSM (men having sex with men) was 20% and in MSM 56.2% (p presence of betalactamase 41.9%, ampicillin 53.1%, amoxicillin/clavulanic acid 9.4%, cefuroxime 9.4%, clarithromycin 18.7%, tetracycline 34.4%, ciprofloxacin 15.6%, and cotrimoxazole 68.7%. Resistance of U. urealyticum was: ciprofloxacin 80.7%, ofloxacin 32.4%, erythromycin 17.5%, azithromycin 9.6%, tetracycline 3.5% and doxycycline 0.8%. Conclusions. N. gonorrhoeae showed a level of resistance to tetracycline and ciprofloxacin higher in the second period, being significant for ciprofloxacin (p