141.3 🩺 內科專科考前版

141.3.0.1 1⃣ 22E 曎新

  • Ceftriaxone 500 mg IM (doubled 2020 from 250 due to MIC creep)
  • Doxycycline 100 BID × 7 d preferred for Chlamydia (replaces azithromycin 1g single)
  • DoxyPEP (200 mg post-exposure within 72 hr): for MSM and transgender women on PrEP — prevents bacterial STI (CDC 2024 recommendation)
  • Mpox (Mpox, monkeypox 2022): primarily MSM; tecovirimat for severe; JYNNEOS vaccine for high-risk
  • HIV PrEP: TAF/FTC daily (Descovy) or TDF/FTC (Truvada); cabotegravir long-acting injectable Q2 months (Apretude)

141.3.0.2 2⃣ XDR Gonorrhea

  • Increasing in Asia, UK, Australia
  • Ceftriaxone resistance: rare but emerging (Asia)
  • Surveillance: NHRI tracking
  • Future: zoliflodacin (in trials), gepotidacin (FDA 2025), solithromycin

141.3.0.3 3⃣ 台灣 context

  • HIV prevalence ~ 0.1%; MSM major route
  • PrEP 健保 2024 give to high-risk MSM (民真自費 / NGO 補助)
  • 梅毒䞊升 in past 5 years (especially MSM, congenital)
  • 公費 syphilis treatment available; congenital syphilis reporting mandatory
  • Mpox (2022 outbreak): JYNNEOS vaccine in high-risk MSM; tecovirimat available via CECC