In developing countries with poor laboratory skills and facilities, a syndrome-based approach was developed and promoted because it was found to be inexpensive, simple, and very cost-effective. In syndromic management, patients are treated at the first visit with a combination of antimicrobials targeting the local probable etiological agents. The mainstay of chancroid treatment is 4 times daily 500 mg of oral erythromycin for 7 days (WHO website: http:// who_hiv_aids_2001.01/index.htm, accessed May 23, 2003). Other current recommended treatment regimens are single doses of either 1 g of azithromycin, 500 mg of ciprofloxacin, or 2 g of spectomycin.[5] If suspicion of infection with Neisseria gonorrhoeae and/or Chlamydia trachomatis exists, azythromycin is additionally effective against H. ducreyi. Although H. ducreyi was initially sensitive to many antibiotics, plasmid-mediated resistance has become an increasing problem worldwide since the 1970s. Resistance was documented for tetracycline, chloramphenicol, sulphonamides, aminoglycosides, and beta-lactam antimicrobial agents.[6] Chromosomally mediated resistance has lately led to decreased sensitivity for penicillin, trimethoprim, and ciprofloxacin.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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