Cefotaxime treatment of Haemophilus ducreyi infection in Kenya.
The authors conducted a double-blind randomized clinical trial comparing single-dose cefotaxime (1 g im) plus daily placebo injections with cefotaxime (1 g im on each of three days). Each regimen was given with probenicid (1 g orally) for the treatment of chancroid. Twenty Haemophilus ducreyi culture-positive men received the single-dose cefotaxime regimen; in eight patients ulcers or buboes failed to respond to therapy. Nineteen H. ducreyi culture-positive men received cefotaxime on each of three days; H. ducreyi was eradicated from all patients, but one had a continuing ulcer and another had a bubo that failed to respond. Thus cefotaxime (1 g im daily for three days) plus probenicid (1 g orally) is effective therapy for chancroid. The lack of efficacy for chancroid of the single-dose cefotaxime regimen is surprising, given the remarkable susceptibility of H. ducreyi to cefotaxime; presumably the half-life of cefotaxime is too short for predictable eradication of H. ducreyi from the ulcer with a single-dose regimen.
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002439:Cefotaxime / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D002602:Chancroid / Q000188:drug therapy* / Q000382:microbiology; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006191:Haemophilus ducreyi / Q000187:drug effects; D006801:Humans; D007630:Kenya; D008297:Male; D008826:Microbial Sensitivity Tests; D011339:Probenecid / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D002439:Cefotaxime; D011339:Probenecid