amoxicillin-potassium-clavulanate-combination and Gonorrhea

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Bacterial Infections; Clavulanic Acids; Clinical Trials as Topic; Drug Therapy, Combination; Evaluation Studies as Topic; Female; Genital Diseases, Female; Gonorrhea; Humans; Respiratory Tract Infections

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Drug Therapy, Combination; Gonorrhea; Humans; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Penicillinase; Treatment Outcome

In a randomised study of two drugs for the oral treatment of uncomplicated urogenital and rectal gonorrhoea the therapeutic effect of cefuroxime axetil ester (CAE) and amoxycillin plus clavulanic acid (A + C) was compared. Cefuroxime axetil ester 1.5 g was given to 129 men and 118 women. Amoxycillin 3.0 g and clavulanic acid 0.25 g was given to 131 men and 122 women. Both treatments were combined with probenecid 1.0 g and administered in a single oral dose. Of the 500 patients thus treated, 376 were assessable. In the group taking CAE, failure rates were 0.9% for the men and 0% for the women; and the overall failure rate was 0.5%. In the group taking A + C the equivalent failure rates were 4.6%, 1.2%, and 3.1%. The differences were not significant. Penicillinase producing Neisseria gonorrhoeae (PPNG) was isolated from 5.6% of the assessable patients. All 10 PPNG infections in the group taking CAE and four of 11 PPNG infections in the group taking A + C were cured. These numbers were too small to draw a definite conclusion about the efficacy of both drugs in this type of infection. Postgonococcal urethritis was observed in 35% of the men in the group taking CAE and in 32% of those in the group taking A + C. Side effects were noted in 38% of the group taking CAE and 28% of the group taking A + C. Nausea and vomiting were more commonly observed in the group taking CAE; and diarrhoea was more commonly observed in the group taking A + C.

Topics: Administration, Oral; Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Cefuroxime; Cephalosporins; Clavulanic Acids; Clinical Trials as Topic; Drug Combinations; Drug Therapy, Combination; Female; Gonorrhea; Humans; Male; Middle Aged; Probenecid; Random Allocation

Topics: Administration, Oral; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clavulanic Acids; Clinical Trials as Topic; Drug Administration Schedule; Drug Combinations; Gonorrhea; Humans; Male; Middle Aged; Penicillinase; Prospective Studies; Time Factors; Urethritis

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Ascites; Bacteremia; Carcinoma, Hepatocellular; Comorbidity; Drug Combinations; Drug Therapy, Combination; Female; Gonorrhea; Hepatitis C, Chronic; HIV Infections; Humans; Ileus; Liver Neoplasms; Multiple Organ Failure; Ofloxacin; Pelvic Infection; Peritonitis

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Evaluation; Drug Therapy, Combination; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Recurrence

Sixty-three women with suspected pelvic inflammatory disease were treated as outpatients with Augmentin with or without doxycycline. Initially, doxycycline was added only after a direct test for Chlamydia trachomatis was positive. Because chlamydial infections were frequent, all patients received doxycycline during the last two thirds of the study. Neisseria gonorrhoeae or Chlamydia trachomatis were recovered from 15 (65%) of 23 women classified as probably having pelvic inflammatory disease. Among 47 women reexamined after starting therapy, three rapidly became worse and were hospitalized, nine (20%) discontinued therapy because of gastrointestinal side effects, and all of the remaining 35 women who completed therapy were either cured or improved.

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Chlamydia Infections; Chlamydia trachomatis; Clavulanic Acids; Doxycycline; Drug Combinations; Drug Therapy, Combination; Female; Gonorrhea; Humans; Pelvic Inflammatory Disease

Single dose Augmentin treatment fails to cure an appreciable proportion of patients infected with penicillinase producing Neisseria gonorrhoeae (PPNG) strains in parts of the world where high levels of chromosomally mediated intrinsic resistance are also present in gonococci. The levels of intrinsic resistance to penicillin of 31 PPNG strains isolated in Sydney were assessed by obtaining beta lactamase negative variants of these strains and measuring the minimum inhibitory concentration of penicillin by agar plate dilution techniques. The levels of intrinsic resistance found in these imported PPNG strains were higher than those recorded for local isolates of non-PPNG strains, which indicates that caution should be exercised in the use of single dose Augmentin treatment of infections with PPNG strains in Sydney.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Australia; Chromosomes, Bacterial; Clavulanic Acids; Drug Combinations; Gonorrhea; Humans; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Penicillin Resistance; Penicillinase

During the three years 1981-3, 134 (9.1%) of 1473 patients presenting at our clinics were found to be infected with penicillinase producing strains of Neisseria gonorrhoeae (PPNG). Minimum inhibitory concentrations (MICs) of benzylpenicillin and ampicillin against these PPNG strains were 8 mg/l or more, whereas against non-PPNG strains they were consistently 4 mg/l or less. In contrast, the MIC of BRL25000 (two parts amoxycillin and one part clavulanic acid, the beta lactamase inhibitor) was 4 mg/l or less even against PPNG strains. MICs of a number of other drugs commonly used to treat gonorrhoea, such as cephaloridine, cefoxitin, tetracycline, doxycycline, minocycline, kanamycin, and spectinomycin, showed no appreciable differences between non-PPNG and PPNG strains and the MIC of cephaloridine in particular was relatively high. BRL25000 proved to be very effective in the treatment of PPNG infection and cured all of 121 patients treated. A daily dose of 2.25g, cured 105 patients in two days, 11 patients in three days, four patients in four days, and one patient in five days. A new rapid diagnostic method for detecting PPNG strains, capable of application at an outpatient clinic and providing a result on the following day, is described.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Clavulanic Acids; Drug Combinations; Female; Gonorrhea; Humans; Japan; Male; Neisseria gonorrhoeae; Penicillinase

In an attempt to investigate the possibility of re-establishing the use of penicillins in the treatment of gonorrhoea in Singapore, a series of studies were conducted between 1981 and 1984, to evaluate the efficacy of a variety of penicillin-clavulanic acid combinations. A total of 6 different regimens were evaluated, and we concluded that 3 regimens consisting of 2 doses of Augmentin 3.25 g P.O., 4 hours apart (regimen C), aqueous procaine penicillin G (APPG) 4.5 mega units I.M. + Augmentin 375 mg + probenecid 1g P.O. (regimen E), and APPG 4.5 mega units I.M. + Augmentin 750 mg + probenecid 1g P.O. (regimen F) were very efficacious against infection due to PPNG and non PPNG. The cure rates obtained were 96.6% (regimens C and E), and 95% (regimen F) for infection due to PPNG and 95.6% (regimen C), and 100% (regimens E and F) for those due to non PPNG. Regimen E consisting of aqueous procaine penicillin G 4.5 meg units I.M. + Augmentin 375 mg + probenecid 1g P.O. was felt to be economical as well as effective against PPNG and non PPNG, and had the potential advantage of being effective against incubating syphillis. Regimen consisting 2 oral doses of Augmentin 3.25 g, 4 hours apart was an effective therapy for patients who preferred oral medication alone. However, this therapy was most costly. No serious side effects of treatment were observed with any of the regimens used.

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Combinations; Drug Therapy, Combination; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Penicillin G; Penicillin Resistance; Probenecid

The efficacy of three penicillin regimens in treating uncomplicated gonorrhoea in men was evaluated. The regimens consisted of: Augmentin 3.25 g plus probenecid 1 g orally: aqueous procaine penicillin G 4.5 MIU intramuscularly and probenecid 1 g plus one tablet of Augmentin 375 mg orally; or aqueous procaine penicillin G 4.5 MIU intramuscularly and probenecid 1 g plus two tablets of Augmentin 375 mg orally. Cure rates for infections caused by penicillinase (beta lactamase) producing Neisseria gonorrhoeae (PPNG) were 87% (20/23) for regimen 1, 97% (28/29) for regimen 2, and 95% (19/20) for regimen 3. Thus the addition of one or two tablets of Augmentin 375 mg to aqueous procaine penicillin G and probenecid cured 96% (47/49) of infections caused by PPNG strains. All three regimens were 100% effective in eradicating infections caused by non-PPNG strains. Post gonococcal urethritis occurred in 24% of cases treated with regimen 1, 14% of cases treated with regimen 2, and 15% of cases treated with regimen 3. The geometric minimum inhibitory concentrations (MIC90) of Augmentin for 72 PPNG and 162 non-PPNG isolates of N gonorrhoeae obtained before treatment were 1.98 and 0.55 mg/l, respectively. Regimen 2, besides being effective against infections caused by PPNG or non-PPNG strains, has the advantage of cost effectiveness and low toxicity. This regimen may be useful in treating gonorrhoea in areas of high prevalence of PPNG strains, such as South East Asia and Africa.

Topics: Acute Disease; Administration, Oral; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Combinations; Gonorrhea; Humans; Injections, Intramuscular; Male; Penicillin G; Penicillin G Procaine; Probenecid

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Combinations; Gonorrhea; Humans; Spectinomycin

We studied 192 men with acute gonococcal urethritis, 97 of whom received two oral doses of Augmentin (amoxycillin 3 g and clavulanic acid 250 mg) separated by a four hour interval; the remaining 95 received 2 g kanamycin in a single intramuscular injection. Of the patients treated with Augmentin, 93 (95.9%) were cured, which was significantly more than the 83 (87.4%) patients treated with kanamycin. Augmentin was equally effective in the treatment of penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG infections, the cure rates for which were 96.6% and 95.6% respectively.

Topics: Acute Disease; Administration, Oral; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clavulanic Acids; Drug Administration Schedule; Drug Combinations; Gonorrhea; Humans; Injections, Intramuscular; Kanamycin; Male; Neisseria gonorrhoeae; Penicillinase; Urethritis