Single dose cefoxitin in treating uncomplicated gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains.

Lim, Kyung-Hwan; Thirumoorthy, T; Lee, C T; Tham, S N; Sng, E H; Tan, Thean Yen

doi:10.1136/sti.62.4.224

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Similar success rates were obtained with 2 doses of intramuscular cefoxitin following a single oral probenecid Ig dose (Jones et al 1979). A reduction in the intramuscular cefoxitin dose to Ig in combination with oral probenecid Ig produced an unacceptably high failure rate of 7% in male patients infected with penicillinase-producing N. gonorrhoeae (Lim et al 1986). This regimen had produced only a 2% failure rate in a previous study (Sanchez et al 1983).…”

Section: Gonorrhoeasupporting

confidence: 62%

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: Gonorrhoeasupporting

confidence: 62%

Cephalosporin-Probenecid Drug Interactions

Brown

1993

Clinical Pharmacokinetics

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“…Cefotetan, the subject of this study, was such a compound that has demonstrated clinical success against gonorrhea (7,11,20). These features are shared with cefoxitin, a similar cephamycin compound (2,12,17,21).…”

Section: U>40mentioning

confidence: 92%

“…Interpretive criteria are proposed for cefotetan based on in vitro data and in vivo considerations (7,8,12,16,18,20). A susceptible category has been defined (MIC, c2 ,ug/ml; zone diameter, -26 mm) that was similar to that of cefoxitin.…”

Section: U>40mentioning

confidence: 99%

“…Susceptibility tests for cefoxitin, another cephamycin, against gonococci have recently been standardized by using GC agar base medium (9). These more simplified procedures should predict the favorable clinicalbacteriologic response to single-dose gonorrhea therapy, e.g., 2 g of cefoxitin plus a predose of 1 g of probenicid (9,12,17,21). Since cefotetan has superior pharmacokinetics compared with those of cefoxitin, probenicid is not required (16).…”

mentioning

confidence: 99%

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Interpretive criteria and quality control guidelines for Neisseria gonorrhoeae susceptibility test standardization for cefotetan

et al. 1991

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Cefotetan was tested in a multilaboratory study to standardize susceptibility testing criteria and quality control guidelines for Neisseria gonorrhoeae. Cefotetan was most active against penicillinase-producing and penicillin-susceptible strains (MIC for 50% of strains tested, 0.5 ,ug/ml) and was least active against the chromosomally resistant isolates (MIC for 50% of strains tested, 2 ,ug/ml). The recommended 30-,ug disk cefotetan interpretive criteria were as follows: susceptible at .26 mm (c2 rig/ml), intermediate at 20 to 25 mm (4 ,ug/ml), and resistant at l19 mm (.8 ,Lg/ml). Quality control guidelines for agar dilution and disk diffusion tests were established by using numerous GC agar lots, three cefotetan 30-,ug disk lots, two quality control organisms, and a volume of tests consistent with National Committee for Clinical Laboratory Standards M23-T guidelines.

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Therapy for Gonococcal Infections: Options in 1989

Moran

Zenilman

1990

Clinical Infectious Diseases

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Single dose cefoxitin in treating uncomplicated gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains.

Cited by 5 publications

References 6 publications

Cephalosporin-Probenecid Drug Interactions

Cephalosporin-Probenecid Drug Interactions

Interpretive criteria and quality control guidelines for Neisseria gonorrhoeae susceptibility test standardization for cefotetan

Therapy for Gonococcal Infections: Options in 1989

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