Effects of Penicillin, Streptomycin, and Tetracycline on N. gonorrhoeae isolated in 1944 and in 1957

Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future

“…Penicillin cured more than 95% of cases, with total doses as low as 45 mg being used (85). However, over time, the MICs of penicillin against gonococcal strains increased due to an accumulation of chromosomal resistance determinants, and the prescribed doses were progressively increased to obtain appropriate cure rates (8,63,(86)(87)(88)(89). Thus, by 1946, four gonorrhea cases resistant to "high" doses of penicillin (0.6 to 1.6 million units) were reported, and this resistance was also verified by in vitro testing.…”

Properties of ß-lactamase from Neisseria gonorrhoeae

“…Remarkably small doses (e.g., 100,000 units altogether) were used to cure gonorrhoea (Mahoney et al 1945), an occurrence reflecting the high susceptibility of the gonococcus to penicillin (Reyn et al 1958). During the subsequent decades a gradual increase in gonococcal resistance to penicillin, documented in the United States (Martin et al 1970) and elsewhere (Amies 1969, Reyn 1961, Arya & Phillips 1979, needed increases in the dose of penicillin as well as the addition of probenecid to maintain effective therapy (Holmes et al 1973, Kaufman et al 1976).…”

Treatment Problems of Gonorrhoea

“…There are difficulties also in the evaluation of sensitivity tests resulting from the fastidious growth requirements of the organism (see Carpenter, page 321). This adds to the importance of the findings in Denmark by Reyn et al (1958), who There would thus appear to be a trend in some areas towards the emergence of strains of gonococci which are relatively less sensitive to penicillin than others. Whether this is due-as seems likely-to the selective multiplication of the less sensitive strains, or to the development of mutants with new metabolic characteristics, is not definitely known.'…”

“…No change as regards the sensitivity of the gonococcus to tetracyclines was noted in the laboratory between 1944 and 1957 (Reyn et al, 1958 and which is not systemically or locally toxic. This is required not only as a further re-3en e fc r the treatment of gonorrhoea but for patients with both gonorrhoea and syphilis who are allergic to penicillin.…”

“…It is also preferred to procaine penicillin as it is better tolerated (Durel & Roiron, 1959). The dose now recommended is 2.0 g (Durel & Roiron, 1959 In areas where streptomycin has not been widely used there has been no obvious deterioration in the results of treatment (Willcox, 1958), and no increasing resistance to streptomycin was noted in the laboratory in Copenhagen between 1944 and (Reyn et al, 1958).…”