Single-dose treatment of uncomplicated acute gonococcal urethritis in Ethiopian men: comparison of rosoxacin, spectinomycin, penicillin, and ampicillin.
A total of 140 Ethiopian men with gonococcal urethritis were randomly assigned to treatment with aqueous procaine penicillin G (4.8 X 10(6) units intramuscularly [im] plus 1.0 g of oral probenicid); oral ampicillin (3.5 g plus 1.0 g of oral probenicid); spectinomycin (2.0 g im); or oral rosoxacin (Acrosoxacin; 300 mg). Failure rates were 24%, 19%, zero, and 3%, respectively. Forty-four (31.4%) patients were infected with penicillinase-producing Neisseria gonorrhoeae (PPNG) and were evenly distributed in the treatment groups. All 39 PPNG strains analyzed for plasmid content possessed a 2.6-Mdalton plasmid; 28 (71.8%) had a 3.2-Mdalton beta-lactamase-encoding plasmid, ten (25.6%) had a 4.4-Mdalton plasmid (three with and seven without a 24.5-Mdalton plasmid), and one had only a 24.5-Mdalton plasmid. Two patients were infected with N. gonorrhoeae-possessing plasmids apparently capable of encoding but not producing beta-lactamase. Both spectinomycin and rosoxacin are excellent single-dose treatment regimens for gonococcal urethritis in men. All people receiving these drugs in Ethiopia should be tested serologically for syphilis, however, as eight (11.8%) of 68 men in this study also had active latent syphilis.
D042462:4-Quinolones; D000667:Ampicillin / Q000008:administration & dosage*; D000890:Anti-Infective Agents; D002986:Clinical Trials as Topic; D005002:Ethiopia; D006069:Gonorrhea / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010400:Penicillin G / Q000008:administration & dosage*; D010402:Penicillin G Procaine / Q000008:administration & dosage*; D011339:Probenecid / Q000008:administration & dosage; D011804:Quinolines / Q000008:administration & dosage*; D015363:Quinolones; D011897:Random Allocation; D000198:Spectinomycin / Q000008:administration & dosage*; D014526:Urethritis / Q000188:drug therapy / Q000209:etiology*
D042462:4-Quinolones; D000890:Anti-Infective Agents; D011804:Quinolines; D015363:Quinolones; D010402:Penicillin G Procaine; C021083:rosoxacin; D000667:Ampicillin; D000198:Spectinomycin; D011339:Probenecid; D010400:Penicillin G