Evaluation of Treatment with Single-dose Ampicillin/Sulbactam with Probenecid or Ceftriaxone in Patients with Uncomplicated Gonorrhea

• Published in: Sexually transmitted diseases 1992-11, Vol.19 (6), p.341-345
• Main Authors: BADDOUR, LARRY M., BUSBY, LINDA, SHAPIRO, ELISE, COX, KAYE B., GLASSCO, SUMNER, JOHNSON, JANET K.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Ampicillin - therapeutic use; Ceftriaxone - adverse effects; Ceftriaxone - therapeutic use; Drug Therapy, Combination; Female; Gonorrhea - diagnosis; Gonorrhea - drug therapy; Humans; Injections, Intramuscular; Male; Middle Aged; Neisseria gonorrhoeae - drug effects; Neisseria gonorrhoeae - enzymology; Original Articles; Penicillinase - biosynthesis; Pharyngeal Diseases - drug therapy; Probenecid - adverse effects; Probenecid - therapeutic use; Rectal Diseases - drug therapy; Sulbactam - therapeutic use; Urethral Diseases - drug therapy; Uterine Cervical Diseases - drug therapy
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/00007435-199211000-00009

This study compared ampicillin/sulbactam plus probenecid with ceftriaxone for treatment of uncomplicated gonorrhea. Of the 297 men and women who were enrolled and randomized to receive either ampicillin/sulbactam (1.0 g/0.5 g) with probenecid (1 g) or ceftriaxone (0.25 g), 274 patients were évaluable. Both ampicillin/sulbactam and ceftriaxone were administered by intramuscular injections. Patients were gonococcal contacts, had positive culture results for Neisseria gonorrhoeae, or had clinical evidence of gonorrhea. Specimens for gonococcal cultures were collected from the cervix (female patients), urethra, rectum, and pharynx at pretreatment and test-of-cure visits. The presence of N. gonorrhoeae and a test-of-cure visit were required for drug efficacy analysis. Of the 274 evaluable patients, 195 (71.2%) had positive culture results for N. gonorrhoeae. Cure was achieved in 93 (94.9%) of 98 patients receiving ampicillin/sulbactam with probenecid and in 96 (99.0%) of 97 patients receiving ceftriaxone. Penicillinase-producing N. gonorrhoeae strains were found in 21 (10.8%) patients; these were eradicated by either ampicillin/sulbactam with probenecid (N = 9) or ceftriaxone (N = 12). Overall, the two drug regimens were very well tolerated and no serious adverse effects were noted. Ampicillin/sulbactam with probenecid may be useful as single-dose therapy in patients with uncomplicated genitorectal gonorrhea.