GETTING RID OF GONORRHOEA

· .. 1M Spectinomycin Hydrochloride Proves Effective in Two Trials Theyal~e 9f S~OJ!J.y'ci!I fpr go~rrh~ was_p0te<! 3:S ,I.ong _~'? ~. 19~f · ~~ tE.~~h}P. _qare. rates . h~ye.l~ee~~eported from various parts oftbe world. The latest reiX>rt is of 138 male and 104 female patients with uncomplicated gonorrha:ea' [11. The men received 2g and the women 48 ofspectinomycin hydrochloride ('Trobicin') 1M in 3.5 and 6.5ml diluent, respectively. The cure­rate was 95-97 96 for the men and almost 100% for the women. No adverse reactions occurred .

. In 110 men with acute gonococcal urethritis treated with speainomycin hydrochloride 28 in a single 1M injection the cure rate in the 7S follow'ed-up was 98 .6 96 (21 Sixty-one of these patients had no further symptoms after the drug was administered. Forty of the 99 gonococcal isolates were sensitive to lOllS! ml and 59 to S)lg l m1 or less of spectinomydn. Serum concentrations averaged I OOllg/ ml after I hour.

· .. And a Single Dose of Oral Talampicillin Gives Good Results Too Ampicillin was introduced in 1961 , and has since become standard oral single-dose treatment for gonorrhoea. Talampicillin hydrochloride ('Talpen:) is a derivative of ampicillin which produces high serum concentrations of ampicillin. In 245 male patients with uncomplicated gonorrhoea, a single dose oftalampicillin 1,48g with probenecid Ig eradicated Ole causative organism in 241 of the patients (98 %) [31. Talampicillin was well tolerated and there were few side-effects. Four patients had a skin reaction. The gonococcus was eradicated in 3 of these 4 patients.

· .. But Unsatisfactory Results With Amoxycillin . ·There have been-several reports of.amoxycillin.usedJoLuncomplicated gonorrhoea •. b.ut,all.r.elate:d \Q ei~r.11. ~.,ggle r~i..men.or _ had no 'blind' element. A double·blind comparisonof2 regimens has now been completed (4~ Amoxycillin Ig phis probenecid Ig as a single dose was given to 97 patients, and amoxycillin 3g plus probenecid I g to foo patients: FiftY in the first group were followed·up for 14 days and 43 (86 %) were cured. 54 in \he setond group were followed·up and S 1 (94.4 %)were·cure<i. These cure rates were unsatisfactory, but there was a high defaulter rate, which tended to lower the cure rate. The higher dose o~ amoxycillin is probably suitable where only 60 % of gonococci are sensitive to the drug.

[I] McCllIJI. J.5. et at.: Journal of the Irish Medicll-l ASSOI:iatiol\ 70: 86 (19 Mar 1977) [2] Porter. J.A. and Ruthcrford. H.W.: British Joumal or vcnereaJ Diseases 53: 115 (Apr 1971) [11 Pm. J .D. e! aI. : Britis.b Journal OrVCMrea! Diseases 53: III (Apr 1977l [4]Thin, R.N. et aI .: Ibid H: 111 (Apr 1977)

INPHARMA 18th julie, 1977 p8