title: Treatment of infections due to multiresistant Neisseria gonorrhoeae with sulbactam/ampicillin.
abstract: Between January and April 1984, 229 of 448 male patients with urethritis at the Choong-Ku Venereal Disease Clinic in Seoul had positive urethral cultures: 66 for penicillinase-producing Neisseria gonorrhoeae (PPNG) and 163 for non-penicillinase-producing N. gonorrhoeae (non-PPNG). Forty-five men with PPNG urethritis were enrolled in a study of the efficacy of treatment with sulbactam/ampicillin plus probenecid. Diagnosis and evaluation of cure were based on culture results. The agar-plate dilution method was used for susceptibility testing, and the chromogenic cephalosporin test was used for detection of beta-lactamases. MICs of various antibiotics for the isolates were high. MICs of sulbactam/ampicillin were 0.25-4 micrograms/ml, with an MIC90 of 4 micrograms/ml, a value 16-fold lower than that for ampicillin alone (MIC90 greater than 32 micrograms/ml). Patients were treated with 1 g of probenecid orally and either one vial of sodium sulbactam/ampicillin or two vials intramuscularly. Each vial contained 0.5 g of sodium sulbactam and 1 g of sodium ampicillin. Patients were followed up for three to five days. All patients but one were cured, and no remarkable adverse reactions were noted. The two regimens of sulbactam/ampicillin were equally effective in the treatment of uncomplicated PPNG in men.
mesh_terms: D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use*; D004338:Drug Combinations / Q000627:therapeutic use; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects; D010397:Penicillanic Acid / Q000627:therapeutic use*; D010403:Penicillin Resistance; D011339:Probenecid / Q000627:therapeutic use; D011897:Random Allocation; D013407:Sulbactam; D014526:Urethritis / Q000188:drug therapy*
chemical_list: D004338:Drug Combinations; C035444:sultamicillin; D000667:Ampicillin; D010397:Penicillanic Acid; D011339:Probenecid; D013407:Sulbactam