title: Cefoxitin as a single-dose treatment for urethritis caused by penicillinase-producing Neisseria gonorrhoeae.
abstract: Gonococci that resist standard penicillin regimens by production of a penicillinase are now well established in certain areas of the world. Because cefoxitin, a semisynthetic cephamycin, resists gonococcal penicillinase in vitro, we compared procaine penicillin G and cefoxitin in treatment of gonorrhea in an area where 40 per cent of isolates produce penicillinase. One hundred and seven men with culture-proved gonococcal urethritis were given a single dose of either procaine penicillin G, 4.8 million U, or cefoxitin, 2 g, intramuscularly. Both groups took 1 g of probenecid orally; cefoxitin was given with lidocaine to reduce pain at the injection site. In men infected with penicillinase-negative gonococci, both cefoxitin and penicillin were highly effective. Penicillin failed in 77 per cent of men with penicillinase-positive strains, whereas cefoxitin was completely successful. Cefoxitin is an effective alternative to spectinomycin for single-session therapy of urethritis caused by penicillinase-producing Neisseria gonorrhoeae.
mesh_terms: D002440:Cefoxitin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000187:drug effects / Q000201:enzymology*; D010402:Penicillin G Procaine / Q000627:therapeutic use; D010403:Penicillin Resistance; D010405:Penicillinase / Q000096:biosynthesis*; D011339:Probenecid / Q000008:administration & dosage; D014526:Urethritis / Q000188:drug therapy*; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D002511:Cephalosporins; D010402:Penicillin G Procaine; D002440:Cefoxitin; D010405:Penicillinase; D001618:beta-Lactamases; D011339:Probenecid