title: Comparative study of ceftriaxone and spectinomycin for treatment of pharyngeal and anorectal gonorrhea.
abstract: Of the currently recommended regimens for treatment of uncomplicated gonorrhea, only aqueous penicillin G procaine is effective against infections at all sites. However, procaine penicillin is not effective against penicillinase-producing Neisseria gonorrhoeae and suffers from poor patient acceptability owing to the 10-mL volume of injection and allergic and toxic procaine reactions. Ceftriaxone is a new extended-spectrum cephalosporin with a long serum half-life and is many times more active than penicillin G against both beta-lactamase-positive or -negative strains of N gonorrhoeae. Ceftriaxone was compared as a single, 125-mg, 0.5-mL injection with a single 2-g injection of spectinomycin in difficult to treat pharyngeal gonorrhea in men and women and anorectal gonorrhea of men. Ceftriaxone cured 30/32 (94%) pharyngeal and 52/52 anorectal infections, compared with 6/14 (43%) and 9/9, respectively, for spectinomycin. Both regimens were well tolerated. Ceftriaxone may prove to be a drug of choice for uncomplicated gonorrhea, particularly where homosexual men are treated and/or penicillinase-producing N gonorrhoeae is prevalent.
authors.forename: F N
authors.initials: FN
authors.lastname: Judson
authors.forename: J M
authors.initials: JM
authors.lastname: Ehret
authors.forename: H H
authors.initials: HH
authors.lastname: Handsfield
mesh_terms: D000328:Adult; D002439:Cefotaxime / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002443:Ceftriaxone; D002986:Clinical Trials as Topic; D003875:Drug Eruptions / Q000209:etiology; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010400:Penicillin G / Q000494:pharmacology; D010612:Pharyngitis / Q000188:drug therapy* / Q000209:etiology; D011349:Proctitis / Q000188:drug therapy* / Q000209:etiology; D000198:Spectinomycin / Q000627:therapeutic use*; D013752:Tetracycline / Q000494:pharmacology
chemical_list: D002443:Ceftriaxone; D000198:Spectinomycin; D013752:Tetracycline; D002439:Cefotaxime; D010400:Penicillin G