title: Single-dose ampicillin/sulbactam versus ceftriaxone as treatment for uncomplicated gonorrhoea in a Ugandan STD clinic population with a high prevalence of PPNG infection.
abstract: During the period November 1989 to March 1991 a total of 330 patients (269 males and 61 females) with signs and symptoms of uncomplicated lower genital tract infections with Neisseria gonorrhoeae were treated at a sexually transmitted disease clinic in Kampala, Uganda. Patients were randomized for treatment with either intramuscular ampicillin/sulbactam (1 g ampicillin/0.5 g sulbactam), plus 1 g probenecid orally, or ceftriaxone (250 mg). In those cases where N. gonorrhoeae was isolated and the patients returned for a follow-up visit, 70/74 (95%) of the patients treated with ampicillin/sulbactam and 71/72 (99%) of those treated with ceftriaxone had favourable clinical outcomes. All 24 patients with penicillinase-producing N. gonorrhoeae (PPNG) treated with ampicillin/sulbactam had a favourable clinical outcome compared with 95% (20/21) of those with PPNG treated with ceftriaxone. The infecting pathogen was eradicated in 65/71 (92%) of the evaluable patients treated with ampicillin/sulbactam and in 60/63 (95%) of the ceftriaxone group. Both drug regimens were well tolerated and there were no reports of adverse drug effects. In summary, in a predominantly male group of clinic patients in Kampala, Uganda, ampicillin/sulbactam was as safe and effective as ceftriaxone in treating uncomplicated gonococcal infections of the lower genital tract caused by either PPNG or non-PPNG strains.
authors.affiliation: University of California, San Francisco, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Hellmann
authors.forename: P S
authors.initials: PS
authors.lastname: Nsubuga
authors.forename: D J
authors.initials: DJ
authors.lastname: Baingana-Baingi
authors.forename: S D
authors.initials: SD
authors.lastname: Desmond-Hellmann
authors.forename: E K
authors.initials: EK
authors.lastname: Mbidde
authors.forename: C B
authors.initials: CB
authors.lastname: Granowitz
authors.forename: M A
authors.initials: MA
authors.lastname: Sande
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000667:Ampicillin / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000201:enzymology; D010405:Penicillinase / Q000096:biosynthesis*; D015995:Prevalence; D011339:Probenecid / Q000627:therapeutic use*; D011446:Prospective Studies; D013407:Sulbactam / Q000627:therapeutic use; D016896:Treatment Outcome; D014454:Uganda
chemical_list: C035444:sultamicillin; D002443:Ceftriaxone; D000667:Ampicillin; D010405:Penicillinase; D011339:Probenecid; D013407:Sulbactam