Penicillin and Spectinomycin in Treatment of Gonococcal Urethritis

• Published in: Sexually transmitted diseases 1982-07, Vol.9 (3), p.135-137
• Main Authors: RATNAM, ATTILI V., PATEL, MOHMEDALI I., HIRA, SUBHASH K., MULENGA, RAPHAEL C.
• Format: Article
• Language: English
• Subjects: Acute Disease; Clinical Trials as Topic; Drug Therapy, Combination; Gonorrhea - complications; Gonorrhea - drug therapy; Gonorrhea - epidemiology; Humans; Male; Neisseria gonorrhoeae - isolation & purification; Neisseria gonorrhoeae - metabolism; Penicillin G Procaine - administration & dosage; Penicillin G Procaine - therapeutic use; Penicillinase - biosynthesis; Probenecid - administration & dosage; Probenecid - therapeutic use; Spectinomycin - administration & dosage; Spectinomycin - therapeutic use; Urethritis - drug therapy; Urethritis - etiology; Urethritis - microbiology; Zambia
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/00007435-198207000-00007

In view of the recent discovery of penicillinase-producing strains of Neisseria gonorrhoeae in Zambia, the efficacies of single intramuscular doses of aqueous procaine penicillin G (4.8 × 10⁶ units plus 1 g of oral probenecid) and 2 g of spectinomycin were evaluated in an open clinical trial of the treatment of acute gonococcal urethritis in men. The former regimen was given to 123 men; failure of treatment was observed in 9.1% of the 88 men followed for two weeks. Spectinomycin was given to 124 men; treatment failure occurred in 3.8% of the 104 men followed for two weeks. During the trial, 190 unselected isolates of N. gonorrhoeae were screened by rapid iodometric test, and two penicillinase-producing strains were detected. MICs of penicillin and spectinomycin were determined by the agar dilution method for 110 and 98 isolates, respectively. MICs of penicillin of ⩾0.125 μg/ml were observed with 78.2% of the strains, while 83.7% had MICs of spectinomycin of ⩽15.0 μg/ml. It was suggested that penicillin be given routinely for treatment of gonorrhea in Zambia and that spectinomycin be reserved for treatment of gonococcal infections not cured by penicillin.