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Treating gonococcal infections resistant to penicillin in Bangkok: comparison of cefuroxime and spectinomycin
Gonococcal organisms have become resistant to antimicrobials throughout the world. Such resistance is common in Thailand, where 40% of gonococci produce penicillinase (PPNG strains) and over half the remainder have MICs of penicillin greater than or equal to 1 mg/l. To evaluate the effectiveness of...
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Published in: | Genitourinary Medicine 1985-10, Vol.61 (5), p.306-310 |
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creator | Chitwarakorn, A Ariyarit, C Panikabutra, K Buateing, A Biddle, J Thompson, S Brown, S |
description | Gonococcal organisms have become resistant to antimicrobials throughout the world. Such resistance is common in Thailand, where 40% of gonococci produce penicillinase (PPNG strains) and over half the remainder have MICs of penicillin greater than or equal to 1 mg/l. To evaluate the effectiveness of cefuroxime against such resistant organisms, a controlled clinical trial comparing spectinomycin and cefuroxime was conducted at Bangrak Hospital, Bangkok, in 1982-3. Of 472 patients who were randomly assigned to treatment, 365 (77%) yielded positive cultures before treatment and returned for follow up evaluation three to 13 days after treatment. Of the 365 patients, 359 (98%) were cured, and no difference between the two treatment regimens was found either by the sex of the patient or by the presence of PPNG strains. The MIC of cefuroxime against all organisms was less than or equal to 1 mg/l. In vitro susceptibilities of gonococci in Bangkok have not changed appreciably during the past two years. Regimens of cefuroxime and spectinomycin are highly effective even for the relatively resistant gonococci in Bangkok. The pharmacokinetics, in vitro susceptibilities, and effectiveness of cefuroxime encourage evaluation of lower doses of the drug. |
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Such resistance is common in Thailand, where 40% of gonococci produce penicillinase (PPNG strains) and over half the remainder have MICs of penicillin greater than or equal to 1 mg/l. To evaluate the effectiveness of cefuroxime against such resistant organisms, a controlled clinical trial comparing spectinomycin and cefuroxime was conducted at Bangrak Hospital, Bangkok, in 1982-3. Of 472 patients who were randomly assigned to treatment, 365 (77%) yielded positive cultures before treatment and returned for follow up evaluation three to 13 days after treatment. Of the 365 patients, 359 (98%) were cured, and no difference between the two treatment regimens was found either by the sex of the patient or by the presence of PPNG strains. The MIC of cefuroxime against all organisms was less than or equal to 1 mg/l. In vitro susceptibilities of gonococci in Bangkok have not changed appreciably during the past two years. Regimens of cefuroxime and spectinomycin are highly effective even for the relatively resistant gonococci in Bangkok. The pharmacokinetics, in vitro susceptibilities, and effectiveness of cefuroxime encourage evaluation of lower doses of the drug.</description><identifier>ISSN: 0266-4348</identifier><identifier>ISSN: 1368-4973</identifier><identifier>EISSN: 1472-3263</identifier><identifier>DOI: 10.1136/sti.61.5.306</identifier><identifier>PMID: 2931346</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Adolescent ; Adult ; Cefuroxime - therapeutic use ; Cephalosporins - therapeutic use ; Clinical Trials as Topic ; Drug Therapy, Combination ; Female ; Gonorrhea - drug therapy ; Humans ; Male ; Penicillin Resistance ; Spectinomycin - therapeutic use ; Thailand</subject><ispartof>Genitourinary Medicine, 1985-10, Vol.61 (5), p.306-310</ispartof><rights>Copyright BMJ Publishing Group LTD Oct 1985</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b511t-6f629c5d13235b16c9e174d402b85e7ad8ee0a4bcc9b2acdbbd75425ae961f493</citedby><cites>FETCH-LOGICAL-b511t-6f629c5d13235b16c9e174d402b85e7ad8ee0a4bcc9b2acdbbd75425ae961f493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1011844/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1011844/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2931346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chitwarakorn, A</creatorcontrib><creatorcontrib>Ariyarit, C</creatorcontrib><creatorcontrib>Panikabutra, K</creatorcontrib><creatorcontrib>Buateing, A</creatorcontrib><creatorcontrib>Biddle, J</creatorcontrib><creatorcontrib>Thompson, S</creatorcontrib><creatorcontrib>Brown, S</creatorcontrib><title>Treating gonococcal infections resistant to penicillin in Bangkok: comparison of cefuroxime and spectinomycin</title><title>Genitourinary Medicine</title><addtitle>Genitourin Med</addtitle><description>Gonococcal organisms have become resistant to antimicrobials throughout the world. Such resistance is common in Thailand, where 40% of gonococci produce penicillinase (PPNG strains) and over half the remainder have MICs of penicillin greater than or equal to 1 mg/l. To evaluate the effectiveness of cefuroxime against such resistant organisms, a controlled clinical trial comparing spectinomycin and cefuroxime was conducted at Bangrak Hospital, Bangkok, in 1982-3. Of 472 patients who were randomly assigned to treatment, 365 (77%) yielded positive cultures before treatment and returned for follow up evaluation three to 13 days after treatment. Of the 365 patients, 359 (98%) were cured, and no difference between the two treatment regimens was found either by the sex of the patient or by the presence of PPNG strains. The MIC of cefuroxime against all organisms was less than or equal to 1 mg/l. In vitro susceptibilities of gonococci in Bangkok have not changed appreciably during the past two years. Regimens of cefuroxime and spectinomycin are highly effective even for the relatively resistant gonococci in Bangkok. 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Ariyarit, C ; Panikabutra, K ; Buateing, A ; Biddle, J ; Thompson, S ; Brown, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b511t-6f629c5d13235b16c9e174d402b85e7ad8ee0a4bcc9b2acdbbd75425ae961f493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1985</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Cefuroxime - therapeutic use</topic><topic>Cephalosporins - therapeutic use</topic><topic>Clinical Trials as Topic</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Gonorrhea - drug therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Penicillin Resistance</topic><topic>Spectinomycin - therapeutic use</topic><topic>Thailand</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chitwarakorn, A</creatorcontrib><creatorcontrib>Ariyarit, C</creatorcontrib><creatorcontrib>Panikabutra, K</creatorcontrib><creatorcontrib>Buateing, A</creatorcontrib><creatorcontrib>Biddle, J</creatorcontrib><creatorcontrib>Thompson, S</creatorcontrib><creatorcontrib>Brown, S</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Genitourinary Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chitwarakorn, A</au><au>Ariyarit, C</au><au>Panikabutra, K</au><au>Buateing, A</au><au>Biddle, J</au><au>Thompson, S</au><au>Brown, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treating gonococcal infections resistant to penicillin in Bangkok: comparison of cefuroxime and spectinomycin</atitle><jtitle>Genitourinary Medicine</jtitle><addtitle>Genitourin Med</addtitle><date>1985-10-01</date><risdate>1985</risdate><volume>61</volume><issue>5</issue><spage>306</spage><epage>310</epage><pages>306-310</pages><issn>0266-4348</issn><issn>1368-4973</issn><eissn>1472-3263</eissn><abstract>Gonococcal organisms have become resistant to antimicrobials throughout the world. Such resistance is common in Thailand, where 40% of gonococci produce penicillinase (PPNG strains) and over half the remainder have MICs of penicillin greater than or equal to 1 mg/l. To evaluate the effectiveness of cefuroxime against such resistant organisms, a controlled clinical trial comparing spectinomycin and cefuroxime was conducted at Bangrak Hospital, Bangkok, in 1982-3. Of 472 patients who were randomly assigned to treatment, 365 (77%) yielded positive cultures before treatment and returned for follow up evaluation three to 13 days after treatment. Of the 365 patients, 359 (98%) were cured, and no difference between the two treatment regimens was found either by the sex of the patient or by the presence of PPNG strains. The MIC of cefuroxime against all organisms was less than or equal to 1 mg/l. In vitro susceptibilities of gonococci in Bangkok have not changed appreciably during the past two years. Regimens of cefuroxime and spectinomycin are highly effective even for the relatively resistant gonococci in Bangkok. The pharmacokinetics, in vitro susceptibilities, and effectiveness of cefuroxime encourage evaluation of lower doses of the drug.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>2931346</pmid><doi>10.1136/sti.61.5.306</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adult Cefuroxime - therapeutic use Cephalosporins - therapeutic use Clinical Trials as Topic Drug Therapy, Combination Female Gonorrhea - drug therapy Humans Male Penicillin Resistance Spectinomycin - therapeutic use Thailand |
title | Treating gonococcal infections resistant to penicillin in Bangkok: comparison of cefuroxime and spectinomycin |
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