cefuroxime-axetil and Gonorrhea

A randomized, multicenter, investigator-blind trial was conducted to compare the efficacies of cefuroxime axetil and ciprofloxacin for treatment of patients with uncomplicated gonorrhea caused by penicillinase-producing Neisseria gonorrhoeae (PPNG). A total of 832 patients (434 females and 398 males) received a single oral dose of cefuroxime axetil (1,000 mg [417 patients]) or ciprofloxacin (500 mg [415 patients]). N. gonorrhoeae was eradicated from the cervix in 114 of 118 (97%) and 118 of 119 (99%) bacteriologically evaluable females treated with cefuroxime axetil and ciprofloxacin, respectively (P = 0.213; difference, -2%; 95% confidence interval, -6 to 1%), and from the urethra in 154 of 166 (93%) and 171 of 171 (100%) bacteriologically evaluable male patients treated with cefuroxime axetil and ciprofloxacin, respectively (P < 0.001; difference, -7%; 95% confidence interval, -11 to -3%). Both treatments were effective in eradicating N. gonorrhoeae in females with rectal infections (cefuroxime axetil, 29 of 30 [97%]; ciprofloxacin, 25 of 25 [100%]; P = 1.00). In small numbers of patients, cefuroxime axetil was less effective than ciprofloxacin in treating males with pharyngeal infections (eradication in 4 of 10 and in 8 of 8 patients, respectively; P = 0.013). PPNG was eradicated from the cervix in 22 of 23 (96%) and 32 of 32 (100%) bacteriologically evaluable female patients treated with cefuroxime axetil and ciprofloxacin, respectively (P = 0.418; difference, -4%; 95% confidence interval, -13 to 4%), and from the urethra in 35 of 36 (97%) and 34 of 34 (100%) bacteriologically evaluable male patients treated with cefuroxime axetil and ciprofloxacin, respectively (P = 1.00; difference, -3%; 95% confidence interval, -8 to 3%). The incidences of drug-related adverse events were similar for the two study drugs. In summary, treatment with a single oral dose of cefuroxime axetil is as effective as treatment with a single oral dose of ciprofloxacin in eradicating PPNG from males and females with uncomplicated gonorrhea (urethral and endocervical), and both regimens are well-tolerated. However, in the present study, cefuroxime axetil was less effective than ciprofloxacin in treating urethral gonococcal infections in male patients, although both study drugs were highly effective in treating cervical gonococcal infections in female patients.

Topics: Adolescent; Adult; Anti-Infective Agents; Cefuroxime; Cephalosporins; Cervix Uteri; Ciprofloxacin; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Neisseria gonorrhoeae; Penicillinase; Treatment Outcome; Urethra

A total of 311 patients presenting with uncomplicated gonorrhoea were entered into a comparative randomized open-label study and given single-dose treatment with either oral cefuroxime axetil (CAE) or intramuscular procaine penicillin (PP). Neisseria gonorrhoeae was eliminated from 129 (98%) of 131 evaluable patients treated with CAE and 127 (98%) of 129 evaluable patients treated with PP. None of the 4 treatment failures (3 male and 1 female) were caused by beta-lactamase-producing isolates. Both treatments were well tolerated with minor adverse events reported in 3 (2%) of CAE treated patients. We conclude that CAE is an effective, well tolerated treatment for uncomplicated gonorrhoea which has the convenience and acceptability of single-dose oral therapy.

Topics: Administration, Oral; Cefuroxime; Cervix Uteri; Female; Follow-Up Studies; Gonorrhea; Humans; Injections, Intramuscular; Male; Neisseria gonorrhoeae; Penicillin G Procaine; Pharynx; Prodrugs; Rectum; Urethra

Four hundred sixty-six female patients were enrolled in a randomized study that compared the clinical efficacies of single oral doses of cefuroxime axetil and amoxicillin with probenecid in the treatment of uncomplicated gonorrhea. Two hundred ninety-five patients had culture-positive gonococcal infections and completed the investigation. Cure rates for the patients treated with cefuroxime axetil and those treated with amoxicillin with probenecid were high (greater than 95%) for genitorectal infections. Pharyngeal infections, however, were not uniformly eradicated by either cefuroxime axetil (60%) or amoxicillin with probenecid (64%). Approximately 13% of each patient group suffered adverse events, which were gastrointestinal in the majority and were transient. Compared with amoxicillin plus probenecid, cefuroxime axetil in a single oral dose was an equally safe and effective drug for the treatment of uncomplicated gonorrhea in women caused by penicillin-susceptible strains.

Topics: Adolescent; Adult; Amoxicillin; Cefuroxime; Cephalosporins; Drug Therapy, Combination; Female; Gonorrhea; Humans; Middle Aged; Probenecid

Topics: Ampicillin; Cefuroxime; Cephalosporins; Clinical Trials as Topic; Drug Therapy, Combination; Female; Gonorrhea; Humans; Male; Probenecid; Random Allocation

Cefuroxime axetil (1.5 g) was compared with amoxicillin (3 g), both given as a single oral dose combined with probenecid (1 g) for the treatment of uncomplicated gonorrhea. Of 60 evaluable patients receiving amoxicillin, 55 (91.7%) were cured, whereas 55 (96.5%) of the 57 patients receiving cefuroxime axetil were cured (P greater than 0.1). Both drugs were well tolerated.

Topics: Amoxicillin; Cefuroxime; Cephalosporins; Drug Therapy, Combination; Female; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Probenecid; Prospective Studies; Random Allocation

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

Oral cefuroxime axetil (1 g) plus probenecid cured 29 of 30 urethral and 6 of 6 rectal gonococcal infections in men; alone the drug cured 22 of 23 urethral and 4 of 6 rectal infections. No toxicity was observed. Cefuroxime axetil alone is effective for urethral gonorrhea in males; rectal gonorrhea probably requires additional probenecid.

Topics: Adolescent; Adult; Aged; Amoxicillin; Cefuroxime; Cephalosporins; Drug Therapy, Combination; Gonorrhea; Humans; Male; Middle Aged; Probenecid; Random Allocation; Rectal Diseases; Urethritis

The social marketing of STD treatment may be a strategy to increase the availability of effective therapy for urethritis in male patients.. To evaluate a pilot project of social marketing of urethritis treatment packages. The project, initially designed for over the counter sale in private pharmacies, was finally restricted by national health authorities to primary healthcare settings in Yaoundé and Douala, Cameroon.. Monthly sales of packages containing antibiotics, condoms, partner referral cards, and written information on STDs were monitored by the social marketing agency. Structured interviews were conducted with a sample of traceable patients who had consulted for urethritis. Structured interviews completed by focus group discussions were conducted among healthcare providers. Interview findings were further validated by a "mystery patient" survey, using surrogate patients. Lastly, 15 key informants among the decision markers involved in the project were interviewed in depth. Local independent consultants carried out the whole evaluation.. A total of 1392 treatment packages were sold in 10 months. Patients who had purchased the package reported high compliance with the treatment, with 99% taking the single dose of cefuroxime-axetil and 83% completing the course of doxycycline. 76% notified all or some partners, and 84% of those who had sex during treatment used condoms. In contrast, only 27% of trained healthcare providers prescribed "MSTOP". They questioned the omission of laboratory diagnosis, the selection of antibiotics, and the duration of therapy. Public health authorities were also sceptical about the choice of antibiotics and viewed the initial project as an overt encouragement of self medication.. Although the MSTOP project was not implemented in the way it had initially been designed, it highlighted the patients' interest in the product. Public health authorities in Cameroon should have been made aware of the limitations of the formal sector's response to STD care among men before over the counter sale of prepackaged therapy could have been considered as an alternative approach to inadequate self medication.

Topics: Anti-Bacterial Agents; Cameroon; Cefuroxime; Chlamydia Infections; Condoms; Doxycycline; Gonorrhea; Health Promotion; Health Surveys; Humans; Male; Nonprescription Drugs; Pamphlets; Pilot Projects; Prodrugs; Self Care; Urethritis

The effectiveness of a single oral dose of Zinnat (cefuroxime axitil) in treating acute gonorrhoea was assessed in 12 men and 2 women who received 1.0 g. the cure rate was 85.7% (12/14). No adverse effect was found. Zinnat was effective, convenient, well tolerated and valuable drug in treatment of acute gonorrhoea.

Topics: Acute Disease; Administration, Oral; Adult; Cefuroxime; Cephalosporins; Female; Gonorrhea; Humans; Male

Topics: Acute Disease; Ampicillin; Anti-Bacterial Agents; Cefuroxime; Clinical Trials as Topic; Drug Therapy, Combination; Female; Gonorrhea; Humans; Male; Probenecid

The efficacy and tolerance of single oral doses of cefuroxime axetil (1.5 g) were compared with oral ampicillin (3 g) for treating acute gonococcal urethritis in 110 men and 30 women. Each dose was given with 1 g probenecid. Of the 62 assessable patients who received ampicillin, two failed to respond to treatment. Of 67 assessable patients who received cefuroxime axetil, one failed to respond. Pencillinase producing strains of Neisseria gonorrhoeae were isolated from five patients; one received ampicillin and failed to respond, whereas the other four received cefuroxime axetil and three were cured. A single oral dose of 1.5 g cefuroxime axetil with 1 g probenecid seemed to be an effective treatment for acute gonococcal urethritis, especially for penicillin resistant strains.

Topics: Adolescent; Adult; Ampicillin; Cefuroxime; Cephalosporins; Female; Follow-Up Studies; Gonorrhea; Humans; Male