title: Need for treatment of gonorrhea to be effective against Chlamydia trachomatis.
abstract: Men and women with gonorrhea or contact to gonorrhea are frequently co-infected with Chlamydia trachomatis. To assess the importance of using treatment regimens active against both Neisseria gonorrhoeae and C trachomatis, tetracycline 500 mg orally four times daily for five days, with activity against both organisms, was compared with ceftriaxone, 250 mg once intramuscularly, with activity against only N gonorrhoeae. N gonorrhoeae microbiological failure occurred in six of 148 patients (4%) on tetracycline and zero of 85 on ceftriaxone. Microbiological failure for C trachomatis occurred in zero of 27 on tetracycline and 10 of 12 (83%) on ceftriaxone (P<0.001). In addition, 14 others on ceftriaxone had C trachomatis first isolated after treatment. When all types of microbiologialc and clinical failures are included, outcome was significantly better on tetracycline (P<0.001). Optimal treatment of patients with gonorrhea must include regimens with activity against both C trachomatis and N gonorrhoeae.
authors.affiliation: Divisions of Infectious Disease and Medical Microbiology, Faculty of Medicine, University of British Columbia; and the Division of Venereal Disease Control and the British Columbia Centre for Disease Control, Ministry of Health, British Columbia.
authors.forename: W R
authors.initials: WR
authors.lastname: Bowie
authors.forename: J
authors.initials: J
authors.lastname: Ast
authors.forename: L
authors.initials: L
authors.lastname: Sibau
authors.forename: C
authors.initials: C
authors.lastname: Shaw
authors.forename: H D
authors.initials: HD
authors.lastname: Jones
authors.forename: W A
authors.initials: WA
authors.lastname: Black