minocycline and Urethritis

Topics: Chlamydia Infections; Female; Genital Diseases, Female; Homosexuality; Humans; Infertility, Male; Lymphogranuloma Venereum; Male; Minocycline; Sexually Transmitted Diseases; Tetracyclines; Urethritis; Uterine Cervicitis

To compare the efficacy and tolerability of minocycline versus doxycycline in the treatment of nongonococcal urethritis and mucopurulent cervicitis.. Randomized, double-blind trial.. Sexually transmitted disease clinics.. 151 men and 102 women with nongonococcal urethritis, mucopurulent cervicitis or whose sexual partner had either condition or a positive culture for Chlamydia trachomatis.. Minocycline, 100 mg nightly, or doxycycline, 100 mg twice daily, each administered for 7 days.. At each visit (days 14 +/- 3, 28 +/- 5, and 49 +/- 7) patients were questioned regarding symptoms, signs, drug compliance, and sexual contact. Cultures for C. trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis were obtained at each visit.. 253 patients were enrolled (133, doxycycline; 120, minocycline). Chlamydia trachomatis was initially isolated from 31% of men and 39% of women. Men with a positive smear had a higher symptom/sign score (P < 0.001) and were more likely to have chlamydia (P = 0.004). Positive endocervical smears were not associated with symptoms or signs (P > 0.2) but correlated with isolation of chlamydia (P < 0.001). One hundred sixty-two patients (64%) completed the study. The proportion with urethritis or cervicitis did not differ by treatment group at any follow-up visit (P > 0.08). Unprotected sexual contact did not affect clinical or microbiological cure rates. Adverse effects occurred more frequently in the doxycycline group (men: 43% versus 26%; P = 0.05; women: 62% versus 35%; P = 0.009). Although the proportion with dizziness did not differ by drug administered (P = 0.1), dizziness was reported more often by women (11% versus 3%).. Minocycline, 100 mg nightly, was as effective as doxycycline, 100 mg twice daily, each given for 7 days in the treatment of nongonococcal urethritis and mucopurulent cervicitis. Vomiting and gastrointestinal upset occurred more frequently in the doxycycline group.

Topics: Adolescent; Adult; Chlamydia Infections; Chlamydia trachomatis; Double-Blind Method; Doxycycline; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Male; Minocycline; Mycoplasma Infections; Recurrence; Suppuration; Ureaplasma Infections; Ureaplasma urealyticum; Urethritis; Uterine Cervicitis

Two hundred and forty four men with non-gonococcal urethritis (NGU) took part in a trial of minocycline. Chlamydiae were isolated from 34%, ureaplasmas from 47.1%, and Mycoplasma hominis from 10.2%. These micro-organisms were isolated least often from men suffering their third or more attack of NGU, and men in this group failed most often to respond to minocycline. Irrespective of the micro-organisms isolated originally or the number of previous attacks, the failure rate (10%) for men receiving minocycline for 10 days was significantly less than for those receiving this antibiotic for one or two days. More than half of the men suffering third attacks from whom micro-organisms were not isolated failed to respond to these short regimens. One of the lowest failure rates (4%) after short term treatment, however, was seen in men experiencing first attacks who yielded only ureaplasmas with or without M hominis, which indicates the importance of ureaplasmas in this group of patients. Chlamydiae were not reisolated from any patient after treatment, irrespective of its duration, and the only ureaplasmas that were reisolated were from nine patients who carried tetracycline resistant strains. Reasons for the absence of chlamydiae and ureaplasmas in the presence of disease and the need to look for other microorganisms as a cause of NGU are discussed among other issues raised by these results.

Topics: Chlamydia; Clinical Trials as Topic; Drug Administration Schedule; Humans; Male; Minocycline; Mycoplasma; Tetracyclines; Time Factors; Ureaplasma; Urethritis

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

Topics: Doxycycline; Drug Combinations; Humans; Minocycline; Random Allocation; Sulfamethoxazole; Tetracyclines; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urethritis

A clinical trial compared the relative efficacy of tetracycline hydrochloride 250 mg qid and minocycline hydrochloride 100 mg bid given for an initial period of ten days to 59 patients suffering from non-gonococcal urethritis (NGU). Those patients with persistent symptoms or signs on completion of the initial course were given a second course for a further ten days at the same dosage. The treatments were equivalent. A significant number of patients not clinically cured after one course of treatment responded satisfactorily to a second course.

Topics: Adolescent; Adult; Drug Evaluation; Humans; Male; Minocycline; New Zealand; Tetracycline; Tetracyclines; Urethritis

A double-blind placebo-controlled study of minocycline in 221 men with non-gonococcal urethritis (NGU) was undertaken. Techniques were used which enabled diagnoses of chlamydial and mycoplasmal infections to be made within 24 hours of a patient attending a clinic. All patients from whom Chlamydia trachomatis was isolated were treated with minocycline, while patients from whom Ureaplasma urealyticum or Mycoplasma hominis was isolated, or from whom no micro-organisms were isolated, were treated on a double-blind basis with either minocycline or placebo. Chlamydia were isolated from 77 (35%) patients and were eradicated by minocycline from 76 (99%). Ureaplasmas were isolated initially from 96 (43%) patients. Treatment with minocycline eradicated them from 43 of 52 (83%) patients, and they disappeared from six of 31 (19%) patients who were treated with placebo. After one week significantly more patients had responded clinically to minocycline than to placebo. The response to minocycline was not influenced by the microbiological status of the patients, which suggests that ureaplasmas are playing a similar role to chlamydia in the pathogenesis of the disease and that an antibiotic-sensitive micro-organism may be producing disease in the isolate-negative group. An immunological approach is required to resolve the problem of the persistent urethral inflammation which occurred despite eradication of the micro-organisms.

Topics: Chlamydia Infections; Chlamydia trachomatis; Clinical Trials as Topic; Double-Blind Method; Humans; Male; Minocycline; Mycoplasma Infections; Mycoplasmatales Infections; Tetracyclines; Ureaplasma; Urethritis

We treated 289 men who had nongonococcal urethritis with minocycline, 100 mg once or twice daily for 7 to 21 days. After 21 +/- 7 days, urethritis persisted or recurred in 31 (27%) of 114 given 7-day therapy and only nine (8%) of 110 given 21-day therapy (p = 0.0005). However, by 49 +/- 14 days, the cumulative percent rate of failure was 31% for 7-day and 30% for 21-day therapy. Thus, 21-day therapy only delayed recurrence. The higher daily dosage did not improve outcome. Urethritis persisted or recurred in 19% of men with initial Chlamydia trachomatis infection. Among men without C. trachomatis, urethritis persisted or recurred in 32% with and 52% without Ureaplasma urealyticum infection (p = 0.03). At follow-up, 79% of cases of persistent or recurrent urethritis were culture negative for C. trachomatis and U. urealyticum. The cause of C. trachomatis-negative, U. urealyticum-negative nongonococcal urethritis, which was least responsive to minocycline therapy, remains uncertain.

Topics: Double-Blind Method; Drug Administration Schedule; Humans; Male; Minocycline; Random Allocation; Tetracyclines; Urethritis

We treated 289 men with nongonococcal urethritis in a randomized, double-blind study with minocycline, 100 mg once or twice daily for 7 or 21 days. Ureaplasma urealyticum was isolated before treatment from 167 (58%). The pretherapy isolates from 82 men re-examined 6 to 8 days after initiation of treatment were viable. In six (7%) isolates were resistant to 256 microgram/mL or more of tetracycline. Tetracycline resistance was significantly correlated with persistence of U. urealyticum and persistence of nongonococcal urethritis during treatment. Recurrence of nongonococcal urethritis after initial resolution and recurrence of U. urealyticum after interim negative cultures were not correlated with tetracycline resistance of U. urealyticum. Thus tetracycline-resistant strains of U. urealyticum are a cause of persistent but not of recurrent nongonococcal urethritis.

Topics: Double-Blind Method; Drug Resistance, Microbial; Humans; Male; Minocycline; Random Allocation; Tetracycline; Ureaplasma; Urethritis

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

The results of a double-blind therapeutic trial on 217 men with nongonococcal urethritis (NGU) show that minocycline was more effective than rifampicin. Before treatment Chlamydia trachomatis was isolated from 43% of men, Ureaplasma urealyticum from 59%, and Mycoplasma hominis from 22%. Chlamydiae and ureaplasmas were isolated less frequently from men with a recent history of NGU. Minocycline was given to 94 patients, and after treatment chlamydiae were isolated from only one of 40 initially chlamydia-positive patients and ureaplasmas from only five of 57 initially ureaplasma-positive patients. Although most patients responded clinically, failure and partial recovery rather than complete recovery were observed more often among those who were infected with ureaplasmas. Rifampicin was given to 123 patients, after which chlamydiae were isolated from only one of 53 initially chlamydia-positive men whereas ureaplasmas, insensitive to the antibiotic in vitro, were isolated from 55 of 68 men who had initially positive results. Patients infected with ureaplasmas failed to respond to rifampicin treatment significantly more often than those who were not infected. This was also observed when only patients who had never had NGU or who had not had a recent episode were considered. Furthermore, 24 (44%) of the 55 men whose ureaplasmas persisted failed to recover whereas only one (7·7%) of 13 men whose ureaplasmas disappeared did not respond to treatment. These results suggested that ureaplasmas were a cause of urethritis in some of the men (an estimated 10% at least). In addition, Reiter's disease developed in two men treated with rifampicin from whom only ureaplasmas had been isolated initially. M. hominis did not seem to have an important pathogenic role in NGU and there was evidence that ureaplasmas were an unlikely cause of urethritis in some men since the organisms persisted despite complete clinical recovery.

Topics: Chlamydia trachomatis; Clinical Trials as Topic; Double-Blind Method; Humans; Male; Minocycline; Mycoplasma; Mycoplasma Infections; Rifampin; Ureaplasma; 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

The results of a double-blind therapeutic trial on 81 men suffering from non-specific urethritis (NSU) show that minocycline was more effective than a placebo. Before treatment Chlamydia trachomatis was isolated from 31 per cent. of the men, ureaplasmas from 58 per cent., and Mycoplasma hominis from 7-5 per cent. There is evidence that chlamydiae are a cause of urethritis. However, after minocycline therapy improvement in the clinical response of patients from whom only ureaplasmas were isolated was less significant, so that the evidence that these organisms are pathogenic is less convincing. Possible reasons for this are discussed, as are the implications of finding minocycline-resistant ureaplasmas in at least 6 per cent. of the patients who harboured these organisms. The symptoms and signs of patients from whom micro-organisms were not isolated also improved after minocycline therapy, implying that the aetiological agents in this group of patients are antibiotic-sensitive. However, the results do not exclude the possibility that a minocycline-resistant agent is the cause of urethritis in a minority of patients.

Topics: Chlamydia; Clinical Trials as Topic; Drug Resistance, Microbial; Humans; Male; Minocycline; Mycoplasma; Tetracyclines; Ureaplasma; Urethritis

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

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

Topics: Clinical Trials as Topic; Humans; Minocycline; Oxytetracycline; Tetracyclines; Urethritis

Sexually transmitted infection (STI) rates in the U.S. have rapidly increased in the past decade. Although most of this rise is due to syphilis, gonorrhea, and chlamydia, less common STIs are also rising, including Mycoplasma genitalium. We present the case of a 40-year-old male with a history of virologically-suppressed human immunodeficiency virus (HIV) infection who presented with recurrent nongonococcal urethritis. Unfortunately, his symptoms were refractory to multiple empiric drug regimens, and he was eventually diagnosed with Mycoplasma genitalium. After consultation with the Centers for Disease Control and Prevention STI branch, minocycline was successfully used to eradicate the infection.

Topics: Adult; HIV Infections; Humans; Male; Minocycline; Mycoplasma genitalium; Mycoplasma Infections; United States; Urethritis

We report a case of

Topics: Anti-Bacterial Agents; Azithromycin; DNA Gyrase; DNA, Bacterial; Humans; Middle Aged; Minocycline; Moxifloxacin; Mycoplasma genitalium; Mycoplasma Infections; RNA, Ribosomal, 23S; Sequence Analysis, DNA; Spectinomycin; Treatment Failure; Urethritis

Mycoplasma genitalium (MG) infection is a sexually transmitted infection that causes up to 25% of nongonococcal urethritis (NGU). MG strains carrying genetic markers of antimicrobial resistance that may affect treatment outcomes are increasingly recognized as a public health concern. We present two cases of persistent MG NGU with strains carrying both macrolide and quinolone resistance-associated mutations that were eradicated successfully by an extended course of minocycline.

Topics: Adult; Anti-Bacterial Agents; Dysuria; Homosexuality, Male; Humans; Male; Minocycline; Mycoplasma genitalium; Mycoplasma Infections; Treatment Outcome; Urethritis

We observed fluoroquinolone treatment failures in 2 men with Mycoplasma genitalium-positive non-gonococcal urethritis in Japan. A fluoroquinolone regimen of sitafloxacin 100 mg twice daily for 7 days failed to eradicate M. genitalium. In both cases, M. genitalium had fluoroquinolone resistance-associated amino acid changes both in GyrA and ParC and a macrolide resistance-associated mutation in the 23S rRNA gene. The emergence of such multi-drug resistant strains can threaten antimicrobial chemotherapy for M. genitalium infections in Japan, because we will lose the first- (azithromycin) and second-line (sitafloxacin) antimicrobial agents to treat M. genitalium infections. We prescribed an extended minocycline regimen of minocycline 100 mg twice daily for 14 days for our patients, and the regimen was successful in eradicating the M. genitalium. The extended minocycline regimen might be an option that we can try when treating multi-drug resistant M. genitalium infections in clinical practice.

Topics: Amino Acid Substitution; Anti-Bacterial Agents; DNA Gyrase; DNA Mutational Analysis; DNA Topoisomerase IV; Drug Resistance, Bacterial; Fluoroquinolones; Humans; Male; Middle Aged; Minocycline; Mycoplasma genitalium; Mycoplasma Infections; Retrospective Studies; Urethritis

Urethral polyp is one of differential diagnoses for the male patients complain of gross-hematuria and/or hematospermia. However, there have been limited numbers of case reports including infectious etiology. Here we reported clinical course and pathological findings of one rare case who was diagnosed and treated as urethral polyp-like lesions on the prostatic urethra caused by Chlamydia trachomatis infection. A 25 year-old man who had a past history of frequent sexual intercourse with unspecified female sexual partner visited the clinic. His chief complaint was gross-hematuria and hematospermia. Endoscopic findings showed that non-specific hemorrhagic polyp-like lesions. To determine the pathological findings including malignant diseases and diagnosis, transurethral resection was performed. Because the pathological findings were similar to those of chlamydial proctitis, additional examination was done. As the results, nucleic acid amplification test of C. trachomatis in urine specimen was positive and immunohistochemical staining of specific chlamydia antigen in resected specimen was also positive. Treatment by orally minocyline 100 mg twice daily for 4 weeks was introduced. After the treatment, symptom was disappeared and nucleic acid amplification test of C. trachomatis in urine specimen turned to be negative. No recurrence was reported 2 years posttreatment.

Topics: Adult; Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Humans; Male; Minocycline; Polyps; Urethritis

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

Using a new plaque cloning technique, we obtained unique Chlamydia trachomatis strains which were confirmed to be free of the 7.5-kb common plasmid and glycogen in inclusions. The in vitro susceptibility of these strains to various chemotherapeutic agents was tested by comparison with their parent strains and clinical isolates possessing the common plasmid. No difference was detected for any of the agents tested, indicating that the 7.5-kb common plasmid is unrelated to the drug resistance of C. trachomatis.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Chlamydia Infections; Chlamydia trachomatis; Clarithromycin; Drug Resistance, Microbial; Erythromycin; Fluoroquinolones; Glycogen; Humans; Male; Microbial Sensitivity Tests; Minocycline; Ofloxacin; Plasmids; Urethritis

Topics: Female; Humans; Minocycline; Urethritis; Uterine Cervicitis

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

The authors followed 56 patients with clinical signs of urogenital phlogosis, due to Chlamydia trachomatis, treated with one of the following antimicrobial agents: miocamycin, minocycline, doxycycline. The results showed that all the antibiotics used were well tolerated and effective against Chlamydia trachomatis.

Topics: Adult; Aged; Chlamydia Infections; Chlamydia trachomatis; Doxycycline; Drug Evaluation; Female; Humans; Male; Middle Aged; Minocycline; Miocamycin; Prostatitis; Urethritis; Vaginitis

The activity of minocycline, doxycycline, tetracycline, erythromycin, mepartricin and lincomycin against 35 freshly isolated Ureaplasma urealyticum strains was tested. Doxycycline was the most active. Twelve strains were resistant to minocycline and four of these were sensitive to erythromycin. Mepartricin showed no activity against the organisms at a concentration of 10 micrograms/ml. The susceptibility of 30 low-laboratory-passage Chlamydia trachomatis strains against tetracycline and erythromycin was tested. A variable degree of sensitivity to tetracycline and erythromycin was found, the median MIC values being 0.13 micrograms/ml and 0.025 micrograms/ml respectively. No resistant Chlamydia trachomatis strain was found.

Topics: Anti-Bacterial Agents; Chlamydia trachomatis; Doxycycline; Erythromycin; Humans; Lincomycin; Male; Mepartricin; Minocycline; Tetracycline; Ureaplasma; Urethritis

The in vitro activity of minocycline (MINO) against Chlamydia trachomatis and its efficacy in the treatment of C. trachomatis-associated nongonococcal urethritis were investigated. Six isolates of C. trachomatis were inhibited at 0.06 micrograms/ml of MINO and 5 isolates at 0.03 micrograms/ml. All cases received oral MINO twice daily for 7 or more days in doses of 100 mg. In 5 of 31 cases, 2 g of spectinomycin was intramuscularly administrated together with MINO only once. C. trachomatis was eliminated in all cases tested. Excellent results were obtained in 26 cases (84%); urethral discharge and polymorphonuclear cells (PMN) disappeared or decreased to normal levels (3 cells/hpf or less) in these cases. Ureaplasma urealyticum was isolated from 8 cases, 7 of which became free of ureaplasmal infection. MINO seemed to be less effective on the decrease of PMN in the urethral smear in cases infected coincidentally with C. trachomatis and U. urealyticum than in cases infected with C. trachomatis alone. No subjective side effects were observed in any of the 31 cases studied. In conclusion, MINO was a useful antimicrobial agent for the treatment of C. trachomatis- and U. urealyticum-associated nongonococcal urethritis.

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Drug Evaluation; Humans; Male; Middle Aged; Minocycline; Tetracycline Resistance; Tetracyclines; Ureaplasma; Urethritis

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

Thirty-nine male patients with urethritis were studied for gonorrhoea or non-gonorrhoea infections. Only 2 patients were infected with N. gonorrhoeae, the other 37 patients were non-gonorrhoea urethritis (NGU). In 9 of these patients, C. trachomatis was identified and in 6 patients, U. urealyticum was isolated. No chlamydial urethritis was combined with ureaplasma. There was no clinical difference between chlamydia and ureaplasma infection, such as serous urethral discharge or mild pyuria. Minocycline was given orally at the dose of 200 mg daily for 7 to 42 days to these patients. Seven of the 9 patients (78%) with C. trachomatis and 7 of the 6 patients (67%) with U. urealyticum infection showed improvement of subjective and objective symptoms after minocycline. In no case, was an adverse reaction noted. Minocycline was effective in the treatment of both C. trachomatis and U. urealyticum urethral infection.

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Drug Evaluation; Humans; Male; Middle Aged; Minocycline; Mycoplasmatales Infections; Tetracyclines; Ureaplasma; 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: Adolescent; Adult; Clostridium; Doxycycline; Female; Humans; Male; Middle Aged; Minocycline; Ureaplasma; Urethritis

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Drug Evaluation; Humans; Male; Middle Aged; Minocycline; Tetracyclines; Urethritis

The epidemiology, diagnostic criteria, and etiology of nonspecific urethritis in men are discussed. Microbiological examinations have indicated that in the vast majority of these patients Chlamydia trachomatis and Ureaplasma urealyticum are the main causes for the disease. Treatment of the disorder has centered on the use of tetracyclinelike drugs, and with proper treatment cure can be obtained in the majority of patients.

Topics: Chlamydia Infections; Chlamydia trachomatis; Doxycycline; Humans; Male; Minocycline; Mycoplasma; United Kingdom; Ureaplasma; Urethritis

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Dose-Response Relationship, Drug; Drug Evaluation; Humans; Male; Minocycline; Mycoplasma Infections; Tetracyclines; Ureaplasma; Urethritis

Topics: Drug Evaluation; Humans; Male; Minocycline; Recurrence; Tetracyclines; Urethritis

The activity of tetracycline hydrochloride and minocycline hydrochloride was compared against 12 strains of Chlamydia trachomatis and Ureaplasma urealyticum; minocycline was more active in vitro against both organisms. A group of 145 men with non-gonococcal urethritis was treated for one week with either tetracycline hydrochloride 500 mg six hourly or minocycline 50 mg twice daily. The clinical results obtained were similar: 61 of 77 (79%) men treated with tetracycline and 53 of 68 (78%) men treated with minocycline were free from urethritis one to two weeks after completing treatment. Both antibiotics were clinically effective against C trachomatis, but activity against U urealyticum was less consistent. Side effects were noted in 14 (18%) men treated with tetracycline and eight (12%) men treated with minocycline; they were predominantly gastrointestinal.

Topics: Chlamydia trachomatis; Humans; Male; Microbial Sensitivity Tests; Minocycline; Tetracycline; Tetracyclines; Time Factors; Ureaplasma; Urethritis

The presence of allugtinins to the causative organism of contagious equine metritis (C.E.M.) in human serum has been confirmed. Agglutinins were found in the serum of 84 (37.6%) of 223 patients with non-gonococcal urethritis (N.G.U.), and in 12.5% of these patients there was a four-fold or greater rise in titre during the course of their illness. There was no evidence that these agglutinins were the result of infection by chlamydiae or ureaplasmas. Certain patients with these agglutinins seemed to respond better to therapy with antibiotics to which the C.E.M. bacterium is susceptible in vitro than did patients in whom these agglutinins were not found. The findings suggest that the C.E.M. bacterium or a microorganism related to it may be aetiologically involved in a proportion of patients with N.G.U. A search for such an organism in these patients is in progress.

Topics: Agglutination Tests; Agglutinins; Animals; Antibodies, Bacterial; Bacterial Infections; Endometritis; Female; Horse Diseases; Horses; Humans; In Vitro Techniques; Male; Minocycline; Rifampin; Urethritis

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

Topics: Chlamydia Infections; Chlamydia trachomatis; Female; Humans; Male; Minocycline; Sexually Transmitted Diseases; Tetracycline; Urethritis

We have currently established the spectrum of sensitivity of the isolated strains to various antibiotics before prescribing the appropriate treatment. A microtechnic has been used. The most active antibiotics are: minocyclin, pristinamycin, erythromycin, chloramphenicol, oxytetracyclin, kanamycin, tobramycin, streptomycin, in this order.

Topics: Anti-Bacterial Agents; Culture Media; Erythromycin; Female; Humans; Hydrogen-Ion Concentration; Male; Microbial Sensitivity Tests; Minocycline; Mycoplasma Infections; Oxytetracycline; Ureaplasma; Urethritis

Topics: Drug Resistance, Microbial; Erythromycin; Humans; Male; Microbial Sensitivity Tests; Minocycline; Mycoplasma; Oxytetracycline; Species Specificity; Tetracyclines; Ureaplasma; Urethritis

In a comparative trial minocycline was the best oral tetracycline compound for twice-daily administration in the treatment of non-specific urethritis. A review six months later showed that 29% of patients had needed further treatment, 35% of these more than one month after initial treatment and 12% between three and six months later. The history revealed no evidence of predisposition to non-specific urethritis among patients in whom relapse occurred. Multiple relapses were in the groups of patients who relapsed earliest. These cases proved more resistant to subsequent treatment, but all patients were eventually cured. The records of female contacts showed that 29% were symptomatic, 44% had an abnormal appearance of the cervix, but only 11% had inflammatory changes detected on cytological smear. A previous report was confirmed that there was no apparent benefit from the empirical treatment of contacts; possible reasons for this are given.

Topics: Adolescent; Adult; Female; Humans; Male; Middle Aged; Minocycline; Oxytetracycline; Recurrence; Tetracycline; Tetracyclines; Urethritis

Topics: Antibodies, Bacterial; Humans; Male; Minocycline; Semen; Ureaplasma; Urethritis

Topics: Ambulatory Care; Female; Humans; Male; Minocycline; Tetracyclines; Urethritis; Urinary Tract Infections

Topics: Adult; Dose-Response Relationship, Drug; Doxycycline; Drug Resistance, Microbial; Humans; In Vitro Techniques; Male; Middle Aged; Minocycline; Mycoplasma; Mycoplasma Infections; Oxytetracycline; Prostatitis; Tetracyclines; Ureaplasma; Urethritis

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

The effect of minocycline on nongonococcal urethritis (NGU) was investigated, with particular reference to its action against Chlamydia trachomatis. Preliminary laboratory studies showed that the drug was active against a laboratory chlamydial strain (Lb4f) in vitro. A group of 133 men with first attacks of NGU was then treated with minocycline, 100 mg twice daily for 3 weeks. Isolates of C trachomatis were obtained from 33 of these men before treatment; all of them gave negative results on cell culture after therapy. Of the 133 patients, 119 (90%) had symptoms on their first attendance, but after one week's treatment only 16 of the 133 (12%) and after 3 weeks 6 of the 133 (5%) had symptoms. All 133 men had demonstrable urethritis initially; by the end of the first week of treatment only 43 of the 133 (32%) and by the end of the third week 32 of the 133 (24%) had evidence of urethritis. There were no differences in clinical response between the Chlamydia-positive and Chlamydia-negative groups. A group of 24 female sexual contacts of men with NGU yielded C trachomatis on cell culture. After 3 weeks' therapy with minocycline all these women gave negative results on cell culture. It is concluded that minocycline is a useful addition to existing remedies for NGU. The future structure of treatment trials for NGU is discussed.

Topics: Animals; Chick Embryo; Chlamydia; Chlamydia Infections; Chlamydia trachomatis; Drug Evaluation; Female; Humans; Male; Minocycline; Tetracycline; Tetracyclines; Urethritis; Uterine Cervicitis

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