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Treatment of Gonorrhea with Trimethoprim-Sulfamethoxazole

1977; Oxford University Press; Volume: 135; Issue: 6 Linguagem: Inglês

10.1093/infdis/135.6.939

1537-6613

W ELLIOTT, Gladys H. Reynolds, Clyde Thornsberry, Douglas S. Kellogg, Harold W. Jaffe, Stuart T. Brown, Janet L. Armstrong, Michael F. Rein,

Pneumocystis jirovecii pneumonia detection and treatment

The following regimens were randomly administered to 271 men with gonococcal urethritis: 4.8 × 106 units of aqueous procaine penicillin G intramuscularly plus 1 g of probenecid orally (APPG); nine tablets of trimethoprim-sulfamethoxazole (TMP-SMZ; 720 mg of TMP and 3,600 mg of SMZ), orally as a single dose (TMP-SMZ-9); and 12 tablets of TMP-SMZ (960 mg of TMP and 4,800 mg of SMZ) orally as two doses of six tablets taken at a 6-hr interval (TMP-SMZ-12). The failure rates of the APPG, TMP-SMZ-9, and TMP-SMZ-12 regimens were 4%, 23%, and 19%, respectively. APPG was significantly more effective (P < 0.05) than TMP-SMZ-9 or TMP-SMZ-12. Isolates of Neisseria gonorrhoeae from treatment failures as compared to those from treatment successes were significantly more resistant to SMZ (P < 0.01) and to the TMP-SMZ combination in a ratio of 19 parts SMZ to one part TMP (P < 0.05). Minimal inhibitory concentrations of SMZ, TMP, TMP-SMZ, and penicillin G showed positive correlation coefficients.