TREATMENT OF GONORRHOEA WITH PENBRITIN. A REPORT OF 200 CASES

Comparison of minocycline and ampicillin in gonococcal urethritis

A prospective, randomised, single-blind trial was carried out to compare the efficacy and tolerability of minocycline and ampicillin in the treatment of gonorrhoea in men. One hundred and twenty men were treated with minocycline 300 mg and 121 men with ampicillin 2 g and probenecid 1 g. Cure rates were similar in both groups of patients. There were few side effects. Of 135 strains of Neisseria gonorrhoeae tested to different concentrations of minocycline and penicillin, two were resistant to penicillin (minimum inhibitory concentration (MIC) greater than or equal to 0.1 microgram/ml) and seven to minocycline (MIC greater than 1.0 microgram/ml). The incidence of PGU was 31% in those patients treated with minocycline and 34% in those treated with ampicillin plus probenecid, the difference not being statistically significant. PGU occurred more often after treatment with minocycline than in previous studies.

Diagnostic treatment and reporting criteria for gonorrhoea in sexually transmitted disease clinics in England and Wales. 2: treatment and reporting criteria

The current methods of treatment and reporting are described. The most common form of treatment for gonorrhoea in men and women was a single dose of oral ampicillin, usually 2 g. In proportionately more of the clinics treating women, treatment was given over several days. The wide use of ampicillin represents a marked change in treatment practice during the last decade. Procaine penicillin was the most commonly used parenteral preparation. The two dosages used most often for men were 1.2 and 2.4 megaunits. In women the commonest regimen was 2.4 megaunits and again there was a tendency for treatment to be given over several days. Epidemiology treatment was used widely and in one-third of clinics this occurred without confirmation that the patient was a true contact. Consultants used varying diagnoses on the quarterly returns for patients treated epidemiologically in whom the smears and/or cultures were negative. Most clinics classified these cases as 'other conditions requiring treatment' (D2) but as many as 19% of clinics designated these cases as being 'true' gonorrhoea. It is suggested that this results in an overestimate of the number of cases of 'real' gonorrhoea treated in England and Wales.

Ampicillin plus probenecid compared with procaine penicillin plus probenecid in the treatment of gonorrhoea

396 male patients with gonococcal urethritis were treated by one of three treatment schedules. Of 132 patients treated with 2.4 m.u. procaine penicillin plus 2 g. probenecid, 109 were followed. There were three (2.8 per cent) recurrences in the first week and none in the second. Of 132 patients treated with 2 g. ampicillin plus 2 g. probenecid, 112 were followed. There were four (3.6 per cent.) recurrences in the first week and three (2.6 per cent.) in the second (total of 6.2 per cent.). Of 132 patients treated with 3 g. ampicillin plus 2 g. probenecid, 115 were followed. There was one (0.8 per cent.) recurrence in the first week and five (4.4 per cent.) in the second (total of 5.2 per cent.). A close correlation was found between the sensitivities of gonococcal strains to ampicillin and to penicillin. The overall sensitivity pattern of N. gonorrhoeae to penicillin had not changed at The London Hospital since the last report in 1972, but there was further evidence of cross-resistance between penicillin and cotrimoxazole.