Rectal gonorrhea in men: diagnosis and treatment.
In a prospective investigation of rectal gonorrhea in men, 1262 patients were studied on the basis of rectal symptoms, gonorrhea contact, or a previously positive rectal culture for Neisseria gonorrhoeae. Five hundred fifty-four patients (44%) had rectal gonorrhea, based on a positive culture; in these patients the symptom of mucus on the stool and the anoscopic finding of generalized exudate proved significant but of low specificity when compared with symptoms and findings in culture-negative patients. Patients were treated with either 4.8 million units of procaine penicillin with 1 g probenecid, 3.5 or 4.5 g of ampicillin with 1 g probenecid, or 9.5 g of tetracycline given over 4 days. Four hundred seven patients with rectal gonorrhea returned for test of cure. Failure rates were 5% with each of the first three regimens and 15% with tetracycline (P less than 3.31). Procaine penicillin with probenecid is recommended as the treatment of choice, with tetracycline being reserved for penicillin-allergic patients.
D000667:Ampicillin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006069:Gonorrhea / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D010402:Penicillin G Procaine / Q000627:therapeutic use; D011339:Probenecid / Q000627:therapeutic use; D011349:Proctitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011351:Proctoscopy; D011446:Prospective Studies; D013752:Tetracycline / Q000627:therapeutic use
D010402:Penicillin G Procaine; D000667:Ampicillin; D013752:Tetracycline; D011339:Probenecid