minocycline and Gonorrhea

The authors report a study carried out on 82 patients affected with gonococcal urethritis, in order to investigate the activity of minocyclin in the prevention of postgonococcal urethritis.

Topics: Chlamydia Infections; Drug Therapy, Combination; Gonorrhea; Humans; Male; Minocycline; Spectinomycin; Tetracyclines; Urethritis

A single dose treatment trial with: spectinomycine 2 g, ampicilline + probenecide 3.5 g + 1 g, thiamphenicol 2.5 g, minocycline 300 mg was undertaken. Three teams were involved, epidemiologists clinicians, microbiologists, 636 patients were included, 483 resumed for control. A negative culture on the third day was considered a success. Failure rates were: spectinomycine 4%, ampicilline-probenecide 3%, thiamphenicol 4%, minocycline 3%. No significant difference was noted between the four rates. The delay of clinical cure was 1.98 days for spectinomycin, 1.87 days for ampicilline - probenecide, 2.16 days for thiamphenicol and 2.12 for minocycline without significant difference. When side effects were analysed, 10% of the patients reported asthenia without difference between the four treatments. Thiamphenicol is responsible for diarrhea 28%, P less than 0,01 minocycline more significantly responsible for guidiness 13%, P less than 0,001, and 18% treated by spectinomycine complained of pain at the time of injection. The antibiotics MIC's are studied. After the analysis of the results, the cost, and the resistances, one treatment was selected.

Topics: Ampicillin; Anti-Bacterial Agents; Drug Combinations; Gonorrhea; Humans; Male; Minocycline; Probenecid; Spectinomycin; Thiamphenicol

In a prospective evaluation of antibiotic prophylaxis against gonorrhea, 1080 men were given 200 mg of oral minocycline or placebo after sexual intercourse with prostitutes in a Far Eastern port. Later, at sea, gonococcal infection was detected in 57 of 565 men given placebo and 24 of 515 men given minocycline (P less than 0.001). Minocycline prophylaxis completely prevented infection by gonococci susceptible to 0.75 microgram or less of tetracycline per milliliter, reduced the risk of infection or prolonged the incubation period in men exposed to gonococci susceptible to 1.0 to 2.0 micrograms per milliliter, but did not prevent infection or prolong incubation in men exposed to gonococci resistant to 2.0 micrograms. Minocycline did not increase the proportion of asymptomatic infections. Minocycline prophylaxis would probably have limited effectiveness as a public-health measure because of the tendency to select resistant gonococci.

Topics: Administration, Oral; Asia, Eastern; Coitus; Drug Evaluation; Drug Resistance, Microbial; Gonorrhea; Humans; Male; Minocycline; Naval Medicine; Neisseria gonorrhoeae; Sex Work; Tetracycline; Tetracyclines; Time Factors; United States; Urethritis

A prospective, randomised, single-blind trial was carried out to compare the efficacy and tolerability of minocycline and ampicillin in the treatment of gonorrhoea in men. One hundred and twenty men were treated with minocycline 300 mg and 121 men with ampicillin 2 g and probenecid 1 g. Cure rates were similar in both groups of patients. There were few side effects. Of 135 strains of Neisseria gonorrhoeae tested to different concentrations of minocycline and penicillin, two were resistant to penicillin (minimum inhibitory concentration (MIC) greater than or equal to 0.1 microgram/ml) and seven to minocycline (MIC greater than 1.0 microgram/ml). The incidence of PGU was 31% in those patients treated with minocycline and 34% in those treated with ampicillin plus probenecid, the difference not being statistically significant. PGU occurred more often after treatment with minocycline than in previous studies.

Topics: Adult; Ampicillin; Clinical Trials as Topic; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Minocycline; Probenecid; Prospective Studies; Random Allocation; Tetracyclines; Urethritis

Topics: Adolescent; Adult; Ampicillin; Drug Administration Schedule; Gonorrhea; Humans; Male; Middle Aged; Minocycline; Recurrence; Talampicillin; Tetracyclines; Urethritis

Topics: Adult; Ampicillin; Drug Combinations; Female; Gonorrhea; Humans; Male; Middle Aged; Minocycline; Probenecid; Sulfamethizole; Sulfamethoxypyridazine; Tetracyclines; Urethritis

Minocycline in a single 300 mg. oral dose was given to 103 men with uncomplicated gonorrhoea, of whom 85 were followed-up for at least 2 weeks. The cure rate in the 85 followed was 94.1 per cent. There were no side-effects. Thus minocycline could be considered as an effective and safe alternative to penicillin in the single-dose treatment of uncomplicated gonorrhoea in the male, but at the moment it is too expensive for routine use.

Topics: Administration, Oral; Adolescent; Adult; Clinical Trials as Topic; Exudates and Transudates; Gonorrhea; Humans; Male; Middle Aged; Minocycline; Tetracyclines; Urethra

Topics: Adult; Clinical Trials as Topic; Gonorrhea; Humans; Male; Minocycline; Tetracycline; Urethritis

Topics: Anti-Bacterial Agents; Drug Synergism; Gonorrhea; Humans; Microbial Sensitivity Tests; Minocycline; Neisseria gonorrhoeae; Tigecycline

We report two cases of conjunctivitis caused by Neisseria gonorrhoeae with reduced cephalosporin susceptibility. Patients showed no response to cefmenoxime eye drops and intravenous ceftriaxone administration. The patients' condition improved after the addition of oral minocycline. The isolates contained the mosaic penA for reduction of β-lactam susceptibility.

Topics: Adult; Anti-Bacterial Agents; Cephalosporins; Conjunctivitis; Drug Resistance, Multiple, Bacterial; Female; Genes, Bacterial; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Minocycline; Neisseria gonorrhoeae; Treatment Outcome

We studied 181 patients diagnosed with male urethritis at Oogaki Municipal Hospital from April 2002 to March 2004. Twenty-two out of 92 patients diagnosed with gonococcal urethritis (GU) and 52 out of 89 patients diagnosed with non-gonococcal urethritis (NGU) were positive for Chlamidia trichomatis by polymerase chain reaction (PCR). Most patients of male urethritis were in their twenties. Of GU patients, 39 (67%) were infected from commercial sex workers (CSWs). Of NGU patients, 12 (30%) were infected from CSWs, 24 (40%) from girl friends and 4 (10%) from their Twenty-eight (48%) out of GU patients were infected through oral sex. spouse. Eighty-three GU patients were treated with SPCM (2 g, one shot). Fifty-five patients could be evaluated for the efficacy of treatment. Elimination rate of Neisseria gonorrhoeae was 100% and 14 out of 18 patients with persisting urethritis had C. trichomatis. Eighty-two NGU patients were treated with minocycline, tosufloxacin, levofloxacin, gatiflixacin or clarithromycine. Sixty-six patients could be evaluated for the efficacy of treatment. Forty-one patients were diagnosed with non-gonococcal chlamydial urethritis (NGCU) and 25 patients were diagnosed with non-gonococcal, non-chlamydial urethritis (NGNCU). The clinical curative rate of NGCU and NGNCU was 93% (38/41) and 80% (20/25), respectively.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Chlamydia Infections; Fluoroquinolones; Gonorrhea; Hospitals, Municipal; Humans; Japan; Levofloxacin; Male; Middle Aged; Minocycline; Naphthyridines; Ofloxacin; Sexual Partners; Sexually Transmitted Diseases, Bacterial; Spectinomycin; Urethritis

Regarding Neisseria gonorrhoeae, the National Committee for Clinical Laboratory Standards (NCCLS) has not defined the breakpoint minimum inhibitory concentration (MIC) for expanded spectrum cephems such as cefpodoxime and ceftizoxime, because of the absence of resistant strains to these antibiotics. To date, in gonococcal urethritis, after treatment with third generation cephems and aztreonam, clinical failures caused by resistant N. gonorrhoeae strains have not been reported. However, we experienced two clinical failures in patients with gonococcal urethritis treated with cefdinir and aztreonam. N. gonorrhoeae isolates from these two patients showed high-level MICs to these agents. The MIC of cefdinir was 1 microg/ml for both strains and that of aztreonam was 8 microg/ml for both strains, while the MICs of other beta-lactams were also higher than the NCCLS value, except for ceftriaxone, for which the MIC was 0.125 microg/ml for both strains. Moreover, the MICs of fluoroquinolones, tetracyclines, and erythromycin against these two isolates were higher than the NCCLS susceptibility value. These isolates were susceptible to spectinomycin. In N. gonorrhoeae, the emergence of these beta-lactam-resistant isolates is of serious concern. However, a more serious problem is that these isolates were already resistant to non-beta-lactam antimicrobials. In Japan, ceftriaxone has not been permitted for clinical use against gonococcal infections. Therefore, in Japan, patients with gonococcal urethritis caused by these resistant N. gonorrhoeae strains should be treated with cefodizime or spectinomycin.

Topics: Adult; Anti-Infective Agents; Aztreonam; Cefdinir; Ceftriaxone; Cephalosporins; Drug Resistance, Microbial; Drug Resistance, Multiple; Drug Therapy, Combination; Fluoroquinolones; Gonorrhea; Humans; Japan; Male; Microbial Sensitivity Tests; Minocycline; Naphthyridines; Neisseria gonorrhoeae; Roxithromycin; Spectinomycin; Urethritis

To assess the activities of two glycylcyclines, N,N-dimethylglycylamido (DMG) derivatives of minocycline (MINO) and 6-demethyl-6-deoxytetracycline (DMDOT), 203 gonococcal isolates recovered at six sexually transmitted disease clinics in the western United States were evaluated. Antimicrobial susceptibilities to tetracycline HCl, doxycycline, MINO, DMG-DMDOT, and DMG-MINO were determined by agar dilution tests. DMG-DMDOT and DMG-MINO were more active than tetracycline HCl, doxycycline, or MINO regardless of the presence of Tet M or of chromosomal mutations mediating tetracycline resistance (P < 0.001).

Topics: Gonorrhea; Humans; Microbial Sensitivity Tests; Minocycline; Neisseria gonorrhoeae; Tetracycline Resistance; Tetracyclines

We reviewed 497 patients with male urethritis diagnosed between January, 1986 and March, 1989 at the Asama General Hospital. The incidence of gonococcal urethritis (GU) was 47.7%, and that of non-gonococcal urethritis (NGU) 52.3%. There was no difference in the age distribution between GU and NGU. Prostitutes were the most common source of the infection in both GU and NGU. Incubation periods were longer in NGU than in GU, statistically. Urethral discharge was the most common symptom. Purulent urethral discharge was seen more commonly than serous urethral discharge in GU. On the contrary, serous urethral discharge was more common in NGU. Penicillin-resistant gonococcus comprised 29.4% and mixed infection of the C. trachomatis existed 25.6% in GU. C. trachomatis was detected in 71.8% in NGU. In GU, new quinolones and penicillins were administered frequently. The effective rates 1 week after the administration were 80.6% and 83.3%, respectively. In NGU, new quinolones and minocycline were administered frequently. The effective rates were 70.4% and 85.3%, respectively. Ofloxacin (OFLX) showed the highest effective rate to NGU among the four new quinolones. The relapse rate for the two-week administration group was lower than that for the one-week-administration group, but the difference was not statistically significant.

Topics: Adolescent; Adult; Child; Gonorrhea; Humans; Japan; Lymphogranuloma Venereum; Male; Middle Aged; Minocycline; Ofloxacin; Penicillins; Quinolones; Retrospective Studies; Sexually Transmitted Diseases; Urethritis

Topics: Adolescent; Adult; Chlamydiaceae Infections; Female; Gonorrhea; Humans; Immunoenzyme Techniques; Male; Middle Aged; Minocycline; Tetracyclines

Clinical observations were made on patients with urethritis, syphilis, chancroid, genital herpes and venereal warts for the last eight years at Gifu City Hospital. The patients with urethritis, genital herpes and venereal warts tended to increase yearly, and the number of the cases with urethritis increased about 2.5 times in the eight years. Slightly more patients had nongonococcal urethritis than gonococcal urethritis excluding 1981. Of the patients with gonococcal urethritis seen between 1977 and 1979, 58% were treated with benzylpenicillin intramuscularly, and 43% of the patients seen between 1980 and 1984 were treated with a concomitant therapy of spectinomycin intramuscularly and minocycline or doxycycline orally. The cure rate for each treatment was 94% and 97%, respectively. Of the patients with nongonococcal urethritis seen between 1980 and 1984, 89% were treated with minocycline or doxycycline orally, and the cure rate was 97%. On the other hand, the cure rate was 43% for the treatment between 1977 and 1979, only 10% of whom had received treatment with minocycline or doxycycline.

Topics: Adolescent; Adult; Aged; Female; Gonorrhea; Humans; Japan; Male; Middle Aged; Minocycline; Penicillin G; Spectinomycin; Urethritis

Two groups of 30 patients each suffering from gonococcal urethritis were treated either with minocyclin for 7 days or with a single administration of penicillin or spectinomycin, respectively. 30% of them revealed an additional infection with C. trachomatis or U. urealyticum. On the 8th day, we observed remaining symptoms in only 20% of the patients treated with minocyclin, but in 40% of the group treated with penicillin/spectinomycin.

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Drug Therapy, Combination; Gonorrhea; Humans; Male; Middle Aged; Minocycline; Penicillins; Recurrence; Spectinomycin; Tetracyclines; Ureaplasma; Urethritis

Topics: Animals; Anti-Bacterial Agents; Asia, Eastern; Bacteria; Cholera; Diarrhea; Doxycycline; Drug Resistance, Microbial; Gonorrhea; Humans; Infection Control; Male; Minocycline; Mucous Membrane; R Factors; Tetracycline; United States

Seventy-two men with gonococcal urethritis were given a single 300-mg dose of minocycline. The failure rate was 13% and the trial was terminated at an early stage. Failure was correlated with increased resistance of Neisseria gonorrhoeae to minocycline. The activity of penicillin, spectinomycin, erythromycin, tetracycline, sulphamethoxazole, cefuroxime, cefotaxime, rosamicin, thiamphenicol, and piperacillin against N. gonorrhoeae were examined in vitro. With the exception of spectinomycin, parallel patterns of resistance to the other antibiotics and minocycline were found. Resistance to spectinomycin was not found, confirming the usefulness of this antibiotic in the treatment of gonorrhoea. The incidence of PGU was significantly lower after a single dose of minocycline than in previous studies.

Topics: Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Drug Administration Schedule; Drug Resistance, Microbial; Gonorrhea; Humans; In Vitro Techniques; Male; Minocycline; Neisseria gonorrhoeae; Tetracyclines; Urethritis

349 male patients with uncomplicated gonococcal urethritis were treated with a single dose of 300 mg. or 400 mg. minocycline hydrochloride. The lower dose gave a lower failure rate, 3-2 compared with 5-1 per cent., but this difference was not statistically significant. The overall known failure rate of 4-2 per cent. compares most favourably with our previous findings in this area using other drugs of the tetracycline group. The incidence of post-gonococcal urethritis (5-1 per cent.) was also the lowest we have found. The few side-effects reported were comparatively trivial. Because of its high degree of therapeutic efficacy, the relatively lack of side-effects, and the reduced incidence of post-gonococcal urethritis, minocycline hydrochloride should be considered the drug of choice whenever single-dose oral treatment is given in uncomplicated gonorrhoea in men.

Topics: Administration, Oral; Follow-Up Studies; Gonorrhea; Humans; Male; Minocycline; Tetracyclines

108 male patients with non-gonococcal urethritis have been treated with minocycline given as two 100 mg. tablets initially, followed by one tablet twice a day over a period of 6 days (13 tablets). Of 96 patients followed, re-treatment for non-gonococcal urethritis within 3 months was undertaken in ten (10.4 per cent.). The findings are compared with those previously reported in seven series involving six other tetracyclines and with nine other treatment regimens. All of the tetracyclines proved superior to other agents and the best results combined with simplicity of administration were obtained with minocycline. Two patients complained of soreness of the mouth after 1 week but no other side-effects were reported. Minocycline thus gives excellent results in the treatment of non-gonococcal urethritis. In the dosage used it was also successful against gonorrhoea in seven patients treated. It is therefore particularly useful in cases in which gonorrhoea is suspected but not found in the smears or in which the smears cannot be read immediately.

Topics: Follow-Up Studies; Gonorrhea; Humans; Male; Minocycline; Tetracycline; Tetracyclines; Urethritis

Topics: Adolescent; Adult; Child; Female; Gonorrhea; Humans; Middle Aged; Minocycline; Tetracyclines

One hundred and thirty-five gonococcal isolates collected from Los Angeles in 1972 were studied for antibiotic susceptibility to penicillin, ampicillin, carbenicillin, tetracycline, minocycline, doxycycline and spectinomycin. Only 12 percent of the isolates were sensitive to 0.05 mug per ml of penicillin while 35 percent required at least 0.5 mug per ml for inhibition of growth. The results were slightly better with ampicillin and nearly the same with carbenicillin. Nineteen percent of the isolates required at least 1.0 mug per ml of tetracycline for inhibition of growth and the results were similar with either minocycline or doxycycline. Forty-nine percent were sensitive to 2.0 mug per ml spectinomycin, but 37 percent required at least 8.0 mug per ml for inhibition of growth. In this study nine of eleven isolates resistant to 1.0 mug per ml of tetracycline were also resistant to both penicillin and spectinomycin. Six came from endocervical sites of female patients who contributed only 37 percent of the total number of isolates studied. Correlation between the agar dilution and disc diffusion methods was satisfactory with penicillin but not with ether tetracycline or spectinomycin.

Topics: Adolescent; Adult; Ampicillin; Anti-Bacterial Agents; California; Carbenicillin; Child; Doxycycline; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Minocycline; Neisseria gonorrhoeae; Penicillin G; Penicillin Resistance; Spectinomycin; Tetracycline

Topics: Adolescent; Adult; Family Characteristics; Follow-Up Studies; Gonorrhea; Humans; Male; Marriage; Middle Aged; Minocycline; Tetracycline; Urethritis

Topics: Administration, Oral; Anemia, Hemolytic; Blood-Brain Barrier; Chlortetracycline; Demeclocycline; Doxycycline; Drug Hypersensitivity; Female; Glucosephosphate Dehydrogenase Deficiency; Gonorrhea; Humans; Injections, Intramuscular; Intestinal Absorption; Male; Methacycline; Minocycline; Oxytetracycline; Penicillins; Tetracycline; Urethritis

Topics: Amino Sugars; Anti-Bacterial Agents; Bacteria; Candidiasis; Carbenicillin; Cephalosporins; Cryptococcosis; Drug Synergism; Flucytosine; Glycosides; Gonorrhea; Humans; Meningococcal Infections; Minocycline; Pseudomonas Infections; Spectinomycin; Sulfonamides; Tetracycline; Trimethoprim