Cefaclor and cefamandole as alternatives to spectinomycin in the treatment of men with uncomplicated gonorrhoea.

Panikabutra, K; Ariyarit, C; Chitwarakorn, Anupong; Saensanoh, C

doi:10.1136/sti.59.5.298

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…A single report of intramuscular cefamandole Ig with oral probenecid Ig producing a failure rate of 29% suggests that this regimen is ineffective for treating N. gonorrhoeae (Panikabutra et al 1983). Alternatively, single intramuscular doses of cefonicid Ig in combination with Ig of probenecid by mouth produced a failure rate of only 2% (Sanchez et al 1984).…”

Section: Gonorrhoeamentioning

confidence: 97%

“…Single oral doses of cefaclor 3g in combination with probenecid Ig have failure rates of 4.2% (Panikabutra et al 1983) and 7% (Tupasi et al 1982), which are less than the failure rate with an equivalent cefaclor dose administered alone (10.4%) [Panikabutra et al 1983]. Multiple day (3) regimens of cefaclor 2, 3 or 4g as a single daily dose in combination with Ig of probenecid produced failure rates of 9, 0 and 0%, respectively (Spagna et al 1979).…”

Section: Gonorrhoeamentioning

confidence: 98%

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Cephalosporin-Probenecid Drug Interactions

Brown

1993

Clinical Pharmacokinetics

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The effect of concurrent probenecid administration on the pharmacokinetics of cephalosporin antibiotics varies with the available cephalosporins. Most cephalosporins are affected to some degree by concurrent probenecid administration, although ceforanide, ceftazidime, ceftriaxone and latamoxef (moxalactam) have no significant changes in pharmacokinetics. For those cephalosporins affected by probenecid, the predominant findings are impairment in renal clearance resulting in increased peak serum concentrations, an increased area under the concentration-time curve (AUC), and both delayed and prolonged recovery of the cephalosporin in the urine. The distribution of the cephalosporins is affected to varying degrees, with reports of increased penetration into ocular, central nervous system and blister fluids noted with some agents. The clinical relevance of the changes in cephalosporin distribution associated with probenecid administration has not been investigated. The dose and timing of probenecid administration appear to be major determinants in any possible interaction. Studies with ceftizoxime and cefoxitin suggest that larger probenecid doses result in greater changes in the pharmacokinetics of cephalosporins. Prolonged probenecid therapy before administration of a cephalosporin did not seem to be as relevant as the probenecid dosage in determining the magnitude of the interaction. Probenecid administration with or immediately before cephalosporin administration appears able to produce these documented changes in cephalosporin pharmacokinetics. The route of administration (oral versus parenteral) of either prolosporin pharmacokinetics. The route of administration (oral versus parenteral) of either probenecid or the cephalosporin does not appear to influence the characteristics of the interactions. The therapeutic efficacy of a combination of a cephalosporin with probenecid has been most thoroughly studied for single-dose treatment of gonorrhoea. The addition of probenecid to cephalosporin therapy results in sustained systemic concentrations adequate for eradication of Neisseria gonorrhoeae. Regimens involving either second or third generation cephalosporins demonstrate good success rates with single-dose therapy. However, the success of ceftriaxone administered alone for treatment of both penicillase-producing and non-penicillase-producing strains of N. gonorrhoeae suggests that the addition of probenecid is unnecessary. The use of probenecid, in combination with cephalosporins, to enhance the treatment of other venereal and systemic infections has preliminary, inconclusive support.

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Section: Gonorrhoeamentioning

confidence: 97%

Section: Gonorrhoeamentioning

confidence: 98%

Cephalosporin-Probenecid Drug Interactions

Brown

1993

Clinical Pharmacokinetics

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“…9 Panikabutra et al published a cure rate of 90% when cefaclor was administered as a 3 g single dose alone in Bangkok, Thailand, and of 96% when 3 g cefaclor and 1 g probenecid were administered jointly, although the difference between the two groups was not statistically significant. 2 Tupasi et al reported a 93% cure rate in 61 female patients with uncomplicated gonococcal infection who were given 3 g single dose with probenecid in Manila, Philippines.3 Finally, Spagna et al reported a cure rate of 98% in a study undertaken in Columbus, Ohio, but with a multiple dose treatment regimen. 4 Cefaclor and cefixime share the advantages of single oral administration, absence of toxicity in pregnancy, and lack of serious side effects.…”

Section: Discussionmentioning

confidence: 99%

Cefaclor, an alternative to third generation cephalosporins for the treatment of gonococcal urethritis in the developing world?

Crabbé

Grobbelaar

Dyck

et al. 1997

Sexually Transmitted Infections

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Drugs of Choice for the Treatment of Uncomplicated Gonococcal Infections

Moran

Levine

1995

Clinical Infectious Diseases

171

124

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Resistance of Neisseria gonorrhoeae to antimicrobial agents continues to spread and intensify. Choosing an antimicrobial regimen requires knowledge of the comparative efficacy of candidate regimens, as delineated in properly conducted clinical trials; their activity against N. gonorrhoeae in vitro; and their pharmacokinetics and toxicity. We tabulated the results of trials of single-dose antimicrobial therapy for uncomplicated gonococcal infection published after 1980. Thirty regimens comprising 21 antimicrobial drugs have been shown to be highly effective for rectal and urogenital infections; the agents involved are cefixime, cefodizime, cefotaxime, cefoxitin, ceftizoxime, ceftriaxone, cefuroxime, cefuroxime axetil, ciprofloxacin, fleroxacin, norfloxacin, ofloxacin, pefloxacin, temafloxacin, azithromycin, aztreonam, netilmicin, rifampin plus erythromycin stearate, sisomicin, and spectinomycin. Few regimens have been shown to be highly effective against pharyngeal infections. Among those antimicrobial agents available for the treatment of uncomplicated gonococcal infections in the United States, ceftriaxone (125 mg), cefixime (400 mg), ciprofloxacin (500 mg), and ofloxacin (400 mg) appear to offer the best balance of proven efficacy and safety.

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Cefaclor and cefamandole as alternatives to spectinomycin in the treatment of men with uncomplicated gonorrhoea.

Abstract: Cefaclor at a dose of 3 g given orally with 1 g probenecid appears to be an effective alternative to spectinomycin 2 g in the treatment of gonorrhoea in areas where strains of penicillinase producing Neisseria gonorrhoeae (PPNG) are prevalent.

Cited by 5 publications

References 13 publications

Cephalosporin-Probenecid Drug Interactions

Cephalosporin-Probenecid Drug Interactions

Cefaclor, an alternative to third generation cephalosporins for the treatment of gonococcal urethritis in the developing world?

Drugs of Choice for the Treatment of Uncomplicated Gonococcal Infections

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