Single Doses of Methacycline and Doxycycline for Gonorrhea: A Cooperative Study of the Frequency and Cause of Treatment Failure

Wiesner, Paul J.; Holmes, King K.; Sparling, P. Frederick; Maness, Michael J.; Bear, David M.; Gutman, Laura T.; Karney, Walter W.

doi:10.1093/infdis/127.4.461

Cited by 47 publications

(15 citation statements)

References 12 publications

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“…Isolates of N. gonorrhoeae were then stored at -70 C in 50% Trypticase soy broth (BBL) and 50% horse serum for subsequent susceptibility testing. The minimal inhibitory concentrations of penicillin G, amoxicillin, ampicillin, and carbenicillin were determined by a method described previously (15) for all isolates recovered after storage. Serial log2 dilutions of each antibiotic were prepared in concentrations ranging from 0.031 to 2.0 lAg/ml in chocolate agar.…”

Section: Methodsmentioning

confidence: 99%

Comparative Therapeutic and Pharmacological Evaluation of Amoxicillin and Ampicillin Plus Probenecid for the Treatment of Gonorrhea

Karney

Turck

Holmes

1974

Antimicrob Agents Chemother

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Single doses of 3.5 g of ampicillin with 1.0 g of probenecid or of 3.0 g of amoxicillin alone were administered orally to 58 males and 56 females with uncomplicated gonococcal infection. The failure rate for genital or anal infection, or both, was 1.7% for ampicillin plus probenecid and 4.2% for amoxicillin alone. However, patients with oropharyngeal infection responded poorly. Seventy-five isolates of Neisseria gonorrhoeae recovered from patients in this study were all inhibited by 1.0 μg or less of ampicillin or amoxicillin per ml; penicillin G, ampicillin, and amoxicillin had similar activity in vitro against these isolates. Serum concentrations of amoxicillin in 10 volunteers remained above the minimal inhibitory concentration for most strains of N. gonorrhoeae for periods up to 10 h after a 3.0-g oral dose. After 2.0 g of ampicillin was given with probenecid, the serum levels during the 5- to 12-h period approached those achieved with 3.5 g of ampicillin plus probenecid, and actually exceeded levels attained during the same interval with 3.0 g of amoxicillin administered alone.

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Section: Methodsmentioning

confidence: 99%

Comparative Therapeutic and Pharmacological Evaluation of Amoxicillin and Ampicillin Plus Probenecid for the Treatment of Gonorrhea

Karney

Turck

Holmes

1974

Antimicrob Agents Chemother

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“…Still, studies comparing the outcome of treatment with the MIC of tetracycline showed a good correlation. A trial of methacycline versus doxycycline showed almost identical response curves for the two drugs when the percentage of patients who failed treatment was plotted against the MIC of the drug used (104).…”

Section: Benefits and Problems Of Astmentioning

confidence: 98%

Antimicrobial susceptibility testing of Neisseria gonorrhoeae and implications for epidemiology and therapy

Fekete

1993

Clin Microbiol Rev

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Antimicrobial susceptibility testing (AST) of Neisseria gonorrhoeae has been under development since the early days of antimicrobial agents. However, it is rarely applied to clinical isolates today. The history of the various in vitro tests to determine the susceptibility of N. gonorrhoeae to antibiotics is rich with evidence that these results predict response to therapy for almost all agents tested. Further, AST is a useful and important aspect of strain characterization and disease epidemiology in conjunction with the more specific but laborious techniques of auxotyping, serotyping, and plasmid analysis. Current technology has overcome many of the objections to AST for N. gonorrhoeae with standardization of test media and the development of an accurate disk diffusion AST method that is suited to most clinical laboratories regardless of volume or level of technical expertise. Ironically, the very low level of resistance to the current primary treatment strategy in the United States, ceftriaxone or another potent cephalosporin, makes the use of AST somewhat superfluous.

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“…Rosoxacin as single oral doses of 300 and 200 mg has been used successfully in 28 of 28 males and 87 of 87 females infected with genital or anorectal penicillinase-producing (PP) N. gonorrhoeae in the Philippines, Indonesia, Kenya (9).…”

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confidence: 99%

Rosoxacin in the therapy of uncomplicated gonorrhea

Romanowski¹,

Austin²,

Pattison³

et al. 1984

Antimicrob Agents Chemother

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In this randomized, multicentered study, 157 males and 130 females with laboratory-confirmed, uncomplicated anogenital Neisseria gonorrhoeae infections were evaluated to determine the efficacy and safety of a single 300-mg oral dose of rosoxacin versus 3.5 g of ampicillin plus 1 g of probenecid. A total of 130 males and 101 females were evaluated. Rosoxacin cured 90.3% (P = 0.053) and 94.1% (P = 0.62), respectively, whereas ampicillin was effective in 98.5 and 98% of males and females, respectively. All 39 patients with anorectal infections were cured. One penicillinase-producing N. gonorrhoeae strain was isolated and was eradicated with rosoxacin. Of 212 pretreatment isolates tested, 201 were inhibited by 0.06 ,ug or less of rosoxacin per ml. The MICs of rosoxacin for the remaining 11 isolates ranged up to 0.5 pLg/ml. A computer-generated balance randomization chart for men and women was provided to each center. Patients were assigned, in order of entry, to receive either a single 300-mg oral dose of rosoxacin or 3.5 g of ampicillin plus 1 g of probenecid. The trial was not double blind. Cure was defined as negative cultures for N. gonorrhoeae 3 to 8 days after treatment.To assess drug toxicity pre-and posttreatment, we carried out complete blood counts, platelet counts, a multichannel 12 biochemical screen, and urinalysis. Adverse reactions were determined by direct questioning at the follow-up visit and were classified by their effect on the central nervous system (CNS), gastrointestinal (GI) system, or other body system. CNS dysfunction included dizziness, drowsiness, headache, euphoria, and altered visual perception whereas GI adverse effects included diarrhea, nausea, or vomiting.

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Single Doses of Methacycline and Doxycycline for Gonorrhea: A Cooperative Study of the Frequency and Cause of Treatment Failure

Cited by 47 publications

References 12 publications

Comparative Therapeutic and Pharmacological Evaluation of Amoxicillin and Ampicillin Plus Probenecid for the Treatment of Gonorrhea

Comparative Therapeutic and Pharmacological Evaluation of Amoxicillin and Ampicillin Plus Probenecid for the Treatment of Gonorrhea

Antimicrobial susceptibility testing of Neisseria gonorrhoeae and implications for epidemiology and therapy

Rosoxacin in the therapy of uncomplicated gonorrhea

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