ro13-9904 and Urethral-Diseases

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Azithromycin; Ceftriaxone; Humans; Levofloxacin; Male; Middle Aged; Nitrofurantoin; Urethra; Urethral Diseases; Young Adult

Cefotaxime is a third-generation cephalosporin with excellent in vitro antimicrobial activity against Neisseria gonorrhoeae, including beta-lactamase-producing strains. A single 1-g intramuscular dose is suitable for the treatment of uncomplicated gonorrhea. We conducted an open, randomized study to evaluate the efficacy, safety, and cost impact of a lower dose (500 mg) of cefotaxime versus 250 mg ceftriaxone, an often recommended treatment for uncomplicated gonorrhea. Of the 222 patients enrolled, the cases of 151 were fully assessable. Bacteriologic elimination rates were 99% in the cefotaxime group and 100% in the ceftriaxone group. Clinical response rates were 78% and 83% in the two groups, respectively. Adverse clinical events occurred in 4% and 9% of patients in the two groups, respectively. The average wholesale price of 500 mg cefotaxime is 31% lower than that of 250 mg ceftriaxone. A 500-mg dose of cefotaxime appears to be a safe and cost-effective alternative to 250 mg ceftriaxone for the treatment of uncomplicated gonorrhea.

Topics: Adolescent; Adult; Cefotaxime; Ceftriaxone; Costs and Cost Analysis; Drug Resistance, Microbial; Female; Gonorrhea; Humans; Injections, Intramuscular; Male; Neisseria gonorrhoeae; Rectal Diseases; Urethral Diseases; Uterine Cervicitis

To establish some characteristics of patients with periurethral gland abscess, its microbiological profile, and response to treatment.. The patients were seen at the Khami Road Clinic, Bulawayo, a municipal STD referral clinic, serving an urban population. Twenty consecutive men with periurethral abscesses were studied. Demographic data and a sexual history were obtained from each patient. Aspirates from the abscess cavities and urethral swabs were collected for microbiology, and blood samples taken for syphilis and HIV serology. The patients were treated by aspiration of the abscess cavities, followed by a single injection of kanamycin 2.0 g followed by a 1 week course of oral doxycycline 100 mg twice daily.. Neisseria gonorrhoeae was cultured from three aspirates and five urethral specimens. Chlamydia trachomatis was found in two aspirates and three urethral specimens. Other organisms isolated included Gram negative and anaerobic bacilli. HIV antibody was detected in 13 of 18 patients tested. The response to initial treatment was good, but the abscesses ruptured in two patients, one of whom developed a urinary fistula. One patient required treatment with an alternative antimicrobial regimen.. This study demonstrated a role for N gonorrhoeae and possibly for C trachomatis in the aetiology of periurethral abscess. The prevalence of HIV infection in these patients was high. The results of treatment of periurethral abscess by aspiration of pus and followed by antimicrobial therapy covering both N gonorrhoeae and C trachomatis were acceptable.

Topics: Abscess; Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Ceftriaxone; Cephalosporins; Chlamydia Infections; Chlamydia trachomatis; Erythromycin; Gonorrhea; Humans; Male; Urethral Diseases