Singapore SUMMARY A total of 136 patients with uncomplicated gonorrhoea were treated with intramuscular cefoxitin 2 g (25 patients) or 1 g ( 11 patients) and oral probenecid 1 g. Cefoxitin 1 g cured 95% (42 out of 45 men and all of 14 women) with infections caused by penicillinase producing Neissera gonorrhoeae (PPNG) strains and 98% (all of 38 men and 13 out of 14 women) with non-PPNG infections, giving an overall cure rate of 96%. The rate ofpostgonococcal urethritis (PGU) in men treated with 1 g cefoxitin was 28%. No serious side effects oftreatment were observed in patients treated with either dose. The failure rate of 7% in men infected with PPNG strains who were treated with the 1 g dose is, however,disturbing. We therefore recommend that intramuscular cefoxitin 2 g and oral probenecid 1 g may be used to treat uncomplicated gonorrhoea, especially in areas where PPNG strains are common.

SUMMARY Norfloxacin, a new oral quinolone, was compared with intramuscular spectinomycin for treating culture proved gonorrhoea (caused by penicillinase producing strains of Neisseria gonorrhoeae (PPNG) and non-PPNG strains.A total of 547 infected men and women were randomly allocated to treatment with either single dose norfloxacin (800 mg by mouth) or spectinomycin (2 g intramuscularly however, they are expensive and thus often beyond the means of those with low incomes, who are at greatest risk. Parenteral treatment is also less convenient to administer than oral medication and is generally less acceptable to patients. Fluorinated quinolone derivatives, such as ciprofloxacin and norfloxacin, have been developed and found to be highly effective against gonococcal infections. They produce their effect by inhibiting bacterial gyrase' and thus disturbing the replication of DNA.8As gonorrhoea is a highly transmissible disease, its quick and efficient eradication from patients is important. To that end, dose response studies with quinolones have focused on the efficacy of single dose administration. Ciprofloxacin is effective in a single dose for treating infections with non-PPNG strains,9whereas single dose enoxacin can cure infections with both non-PPNG and PPNG strains in a population with a low incidence of PPNG.' Norfloxacin in single dose has been shown to cure non-PPNG and PPNG 235 on 1 May 2019 by guest. Protected by copyright.