Treatment of acute gonococcal infections in Bangkok with a dose range of the new cephalosporin, cefodizime.
In this randomized dose range study conducted in Bangkok, 326 patients with presumed acute uncomplicated gonorrhoea were treated with a single intramuscular dose of either 0.25 g, 0.5 g, or 1.0 g of a new aminothiazole cephalosporin, cefodizime. One hundred and eighty men and 110 women were evaluable for efficacy. Pathogens were eliminated in all but 4 of these patients resulting in a cure rate of 99%, irrespective of dose, sex, or multiplicity of infected sites. A high percentage of the 290 strains of Neisseria gonorrhoeae isolated from the evaluable patients showed resistance to penicillin, and 40% were penicillinase producing (PPNG). The minimum inhibitory concentration of cefodizime for 90% of the PPNG strains was less than 0.04 mg/l. No clinically relevant adverse drug reactions were reported. This study demonstrates that a single 0.25 g dose of cefodizime is effective against both PPNG and non-PPNG strains in a geographic region characterized by high endemic antibiotic resistance.
Chitwarakorn
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A
Office for Communicable Disease Control, Region 1, Department of Communicable Disease Control, Bangkok, Thailand.
Wongba
C
C
Dagrosa
E E
EE
Schinzel
B
B
D000293:Adolescent; D000328:Adult; D002439:Cefotaxime / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010403:Penicillin Resistance; D010405:Penicillinase / Q000096:biosynthesis; D013785:Thailand / Q000453:epidemiology
D010405:Penicillinase; D002439:Cefotaxime; C033356:cefodizime