A single dose of ceftriaxone (250 mg) administered intramuscularly was compared with trimethoprim-sulfamethoxazole (TMP-SMZ; 160/800 mg) administered orally twice daily for seven days or with a single dose of TMP-SMZ (640/3,200 mg) administered orally for the treatment of chancroid in men in Thailand. Haemophilus ducreyi was isolated from 79 (48%) of 164 men with a clinical diagnosis of chancroid. For men with ulcers that were culture positive for H. ducreyi, rates of cure were 100% in 25 men treated with ceftriaxone, 87% in 23 men given TMP-SMZ for seven days, and 55% in 31 men given TMP-SMZ in a single dose. For men with ulcers that were culture negative for H. ducreyi, rates of cure were 100% in 29 men treated with ceftriaxone, 66% in 32 men given TMP-SMZ for seven days, and 63% in 24 men given TMP-SMZ in a single dose. The MIC50 of the three antibiotics for 94 isolates of H. ducreyi were as follows: 0.004 micrograms/ml for ceftriaxone, 16 micrograms/ml for trimethoprim, and greater than 512 micrograms/ml for sulfamethoxazole. Our study indicates that ceftriaxone in a single dose of 250 mg is effective, but that TMP-SMZ, even when given in a standard seven-day regimen, is not effective treatment for chancroid in Thailand.

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A randomised double blind trial comparing single oral dose therapy with 200 mg and 400 mg of ofloxacin, respectively was conducted at the Bangrak Hospital, Bangkok during the period December 6, 1985 to January 24, 1986. We treated 234 male patients diagnosed as having uncomplicated gonococcal urethritis with ofloxacin. Ofloxacin, at a single dose of 200 mg or 400 mg, was given to each of them. Fourteen patients were excluded for efficacy assessment. There were 223 patients left for safety assessment. The cure rates were 100% in both groups. Among 233 isolates tested, 48.5% were penicillinase producing Neisseria gonorrhoeae. The range of minimum inhibitory concentrations of ofloxacin was 0.008 to 0.063 mg/l. No adverse drug experiences were reported.

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.

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