Single-dose treatment of uncomplicated gonorrhea: a comparison of cefonicid and penicillin.
Cefonicid, a parenteral semisynthetic cephalosporin, achieves high and sustained serum levels in humans. Activity against strains of Neisseria gonorrhoeae, including those that produce beta-lactamase, has been shown in vitro. The efficacy of 1.0 g of cefonicid was evaluated noncomparatively in 50 men with gonococcal urethritis; four failed to respond to treatment. Additionally, 57 men and 34 women received either 1.0 g of cefonicid or 4.8 X 10(6) units of procaine penicillin G plus 1.0 g of probenecid in a double-blind study. Among 17 men treated with penicillin, two failed to respond, and one failed among the 33 patients treated with cefonicid. Seventeen women received 1.0 g of cefonicid, and all cervical infections were cured. Among those who received cefonicid, 13 had rectal infections; and four had positive cultures at follow-up four to seven days posttreatment. Among the 17 women receiving penicillin, none failed to respond to therapy; only seven had both cervical and rectal infection. Of the 116 pretreatment and seven posttreatment isolates tested, 45 (37%) were inhibited by less than 0.0625 microgram of penicillin/ml and 121 (98%) were inhibited by less than 1.0 microgram/ml. Forty-one (33%) of the 123 isolates were inhibited by less than 0.0625 microgram of cefonicid/ml and 122 (99%) by less than 1.0 microgram of cefonicid/ml. The median MIC of cefonicid for the strains isolated from the women whose rectal infections were cured was 0.125 microgram/ml; that for the strains isolated from the women with rectal infections who failed to respond was 0.5 microgram/ml. Administration of 1.0 g of cefonicid intramuscularly is effective therapy for uncomplicated gonococcal urethritis in men.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D002435:Cefamandole / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015790:Cefonicid; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects; D010400:Penicillin G / Q000008:administration & dosage*; D010402:Penicillin G Procaine / Q000008:administration & dosage* / Q000627:therapeutic use; D011339:Probenecid / Q000627:therapeutic use; D011897:Random Allocation; D013997:Time Factors
D010402:Penicillin G Procaine; D002435:Cefamandole; D015790:Cefonicid; D011339:Probenecid; D010400:Penicillin G