rosoxacin and Gonorrhea

The treatment of gonococcal infections by quinolones is reviewed. Acrosoxacin is effective, but side effects are relatively common. Ciprofloxacin is effective in single dosage against urogenital gonococcal infections, and probably also against rectal and pharyngeal infections. It is effective against infections by penicillinase-producing Neisseria gonorrhoeae. In vitro, ciprofloxacin is active against Chlamydia trachomatis, and preliminary results indicate that this drug may be of value in the treatment of non-gonococcal urethritis and chlamydial infection. No major side effects of ciprofloxacin therapy in patients with these infections have been reported.

Topics: 4-Quinolones; Anti-Infective Agents; Anti-Infective Agents, Urinary; Chlamydia Infections; Chlamydia trachomatis; Ciprofloxacin; Gonorrhea; Humans; Norfloxacin; Quinolines; Quinolones; Urethritis

A total of 112 male patients presenting with acute gonococcal urethritis were admitted to the hospital. The diagnosis was confirmed by smear, culture, oxidase reaction and sugar fermentation tests. The patients were treated with a single 300 mg capsule of rosoxacin. All patients except one showed adequate response to rosoxacin.

Topics: 4-Quinolones; Acute Disease; Adolescent; Adult; Anti-Infective Agents; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Quinolones; Urethritis

A single dose of 300 mg of the quinoline carbonic acid derivative rosoxazin (Winuron) was used for treatment of 59 men with uncomplicated gonorrhoea and two males with fresh infection with penicillin-resistant gonococci. Within 48 hours full clinical remission was seen in all 61 cases confirmed bacteriologically for gonococci. Concomitant infection with other pathogens transmitted by intercourse, present in 69% of cases, could not be influenced or changed by this treatment. Tolerance was good: 21 patients (32%) complained of slight side effects, however, only 3 patients (5%) showed significant central nervous or gastrointestinal symptoms. Rosoxazin has the great advantage of reliable effectiveness even in case of penicillin-resistant gonococci. Thus, the substance offers an effective and well-tolerated orally applicable and reasonably priced alternative to conventional treatment of gonorrhoea.

Topics: 4-Quinolones; Adolescent; Adult; Anti-Infective Agents; Clinical Trials as Topic; Drug Evaluation; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Penicillin Resistance; Quinolines; Quinolones

Topics: 4-Quinolones; Administration, Oral; Anti-Bacterial Agents; Gonorrhea; Humans; Neisseria gonorrhoeae; Penicillin Resistance; Penicillins; Quinolines; Quinolones

Between 3 January and 4 March 1983 we treated 200 male patients diagnosed as having uncomplicated gonococcal urethritis with one of two regimens. They were divided into two groups and randomly assigned to treatment with either 2 g spectinomycin administered intramuscularly (group A) or 300 mg rosoxacin by mouth (group B). Of 187 isolates tested for the production of beta-lactamase, 101 (54%) were penicillinase producing Neisseria gonorrhoeae (PPNG) strains. All 81 cases followed in group A (spectinomycin) were cured, compared with 88.5% (77 out of 87) of the patients followed in group B (rosoxacin). We concluded that rosoxacin at a dosage of 300 mg administered orally was fairly effective in the treatment of gonococcal urethritis in men caused by both PPNG and non-PPNG strains.

Topics: 4-Quinolones; Anti-Bacterial Agents; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Penicillinase; Quinolines; Quinolones; Spectinomycin; Urethritis

Topics: 4-Quinolones; Anti-Infective Agents; Clinical Trials as Topic; Female; Gonorrhea; Humans; Male; Quinolines; Quinolones

In this randomized, multicentered study, 157 males and 130 females with laboratory-confirmed, uncomplicated anogenital Neisseria gonorrhoeae infections were evaluated to determine the efficacy and safety of a single 300-mg oral dose of rosoxacin versus 3.5 g of ampicillin plus 1 g of probenecid. A total of 130 males and 101 females were evaluated. Rosoxacin cured 90.3% (P = 0.053) and 94.1% (P = 0.62), respectively, whereas ampicillin was effective in 98.5 and 98% of males and females, respectively. All 39 patients with anorectal infections were cured. One penicillinase-producing N. gonorrhoeae strain was isolated and was eradicated with rosoxacin. Of 212 pretreatment isolates tested, 201 were inhibited by 0.06 micrograms or less of rosoxacin per ml. The MICs of rosoxacin for the remaining 11 isolates ranged up to 0.5 micrograms/ml. The incidence of adverse effects was relatively high (29% for the rosoxacin group versus 18% for the ampicillin group), but none of the reactions required medical intervention nor did they result in serious sequelae.

Topics: 4-Quinolones; Adult; Ampicillin; Anti-Bacterial Agents; Clinical Trials as Topic; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Pharynx; Probenecid; Quinolines; Quinolones; Random Allocation; Sex Factors

152 ambulatory patients suffering from gonorrhoea were treated with Winuron in an open clinical trial. A single oral dose of rosoxacin 300 mg proved to be sufficient to cure 97.4% of the patients. Follow-up examination revealed only 4 cases of Neisseria gonorrhoea left. Already 3 days after therapy, the clinical symptoms had subsided in 84.1% of the patients. The substance was well-tolerated. Side effects were observed in 14.5% of the cases, being mild and transitory, though. Good and antibacterial efficacy of rosoxacin in vitro as well as the high healing quotient in combination with the shortest possible duration of therapy make Winuron a valuable alternative to penicillin.

Topics: 4-Quinolones; Adult; Anti-Infective Agents; Chemical Phenomena; Chemistry; Clinical Trials as Topic; Dose-Response Relationship, Drug; Female; Gonorrhea; Humans; Male; Quinolines; Quinolones

Topics: 4-Quinolones; Adolescent; Adult; Anti-Infective Agents; Clinical Trials as Topic; Gonorrhea; Humans; Male; Quinolines; Quinolones; Urethritis

Topics: 4-Quinolones; Anti-Bacterial Agents; Anti-Infective Agents; Clinical Trials as Topic; Gonorrhea; Humans; Quinolines; Quinolones

In a randomized, double-blind, dose-ranging study, single oral doses of rosoxacin were used to treat 126 patients with uncomplicated genital or anorectal gonorrhea. Neisseria gonorrhoeae was eradicated from 5 (28%) of 18 men treated with 100 mg, compared with 101 (94%) of 108 men and women treated with 200 mg, 300 mg, or 400 mg (P less than 0.001). Susceptibility to rosoxacin was determined for 6 pretreatment gonococcal isolates from these patients and for 194 stored clinical isolates; 296 (98.7%) of these 300 isolates, including 10 strains of penicillinase-producing N. gonorrhaeae, required a minimal inhibitory concentration of less than or equal to 0.062 microgram/ml. Urethral or cervical infection with Chlamydia trachomatis coexisted with gonococcal infection in 14 (22%) of 63 patients and persisted in 7 of 10 patients treated with rosoxacin. Postgonococcal urethritis developed in 11 (34%) of 32 men who were monitored for 12 to 30 days. Sixty-four subjects (51%) developed transient dizziness, drowsiness, altered visual perceptions, or other symptoms suggestive of central nervous system dysfunction after treatment with rosoxacin, but these symptoms were not clearly dose related. Rosoxacin in doses of greater than or equal to 200 mg appears to be effective for single-dose treatment of uncomplicated gonorrhea, but further studies of its possible central nervous system toxicity are indicated.

Topics: 4-Quinolones; Adolescent; Adult; Anti-Bacterial Agents; Chlamydia trachomatis; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Quinolines; Quinolones; Urethritis

Topics: 4-Quinolones; Anti-Infective Agents; Bibliographies as Topic; Female; Gonorrhea; Humans; Male; Quinolines; Quinolones

An open study was designed primarily to evaluate the efficacy of rosoxacin in the treatment of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains. A total of 199 patients (99 men and 100 women) satisfactorily completed follow up examinations, 50 men and 50 women having received rosoxacin 300 mg orally and the remainder having received kanamycin 2 g intramuscularly. Rosoxacin achieved an overall cure rate of 94% (96.7% for PPNG and 90% for non-PPNG strains). In patients treated with kanamycin the overall cure rate was 89.9% (92.7% for PPNG and 83.3% for non-PPNG strains). A correlation between treatment failures and minimum inhibitory concentrations (MICs) of rosoxacin was noted in non-PPNG strains but not in PPNG strains. Side effects which were mild and self limiting were noted in 15 of 100 patients treated with rosoxacin. The high failure rates associated with non-PPNG strains requiring MICs of 0.125 mg/l and the observation of a substantial rise in the MICs for isolates after treatment is of concern. Otherwise, rosoxacin in a single dose of 300 mg appears to be safe and effective for the treatment of uncomplicated gonorrhoea.

Topics: 4-Quinolones; Anti-Bacterial Agents; Female; Gonorrhea; Humans; Kanamycin; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Penicillinase; Quinolines; Quinolones; Sex Work

The high endemicity of PPNG in some regions preclude the continued routine use of procaine penicillin as treatment for gonorrhoea. The aminoglycosides, spectinomycin, second and third generation cephalosporins are highly effective and on epidemiological grounds, should replace penicillin as the first choice antibiotic. However, due cognizance has to be given to the impact of this recommendation on the non PPNG strains and the development of chromosomal resistance to the latter antibiotics. Also, the discontinuation of penicillin as the first line drug for gonorrhoea may see a resurgence of early syphilis. All future recommendations on the treatment of gonorrhoea should take these factors into consideration. Synergetic combination of beta lactam antibiotics and beta lactamase inhibitors or combination therapy may be the lines along which future research should head.

Topics: 4-Quinolones; Anti-Bacterial Agents; Anti-Infective Agents; beta-Lactamases; Cephalosporins; Gentamicins; Gonorrhea; Humans; Kanamycin; Neisseria gonorrhoeae; Penicillin Resistance; Penicillinase; Penicillins; Quinolines; Quinolones; Spectinomycin; Thiamphenicol

Topics: 4-Quinolones; Adolescent; Adult; Anti-Infective Agents; Anti-Infective Agents, Urinary; Female; Gonorrhea; Humans; Male; Middle Aged; Quinolines; Quinolones; Urethritis

Acrosoxacin was given as a single 300 mg oral dose to 105 patients with acute gonorrhoea. Of the 100 patients followed completely there was a 93% cure rate and 33% of men developed postgonococcal urethritis (PGU). This compared with a 97% cure and 30% PGU with 2 megaunits penicillin. The in vitro activity of acrosoxacin in Nottingham against strains of Neisseria gonorrhoeae showed that it was a highly active agent with 90% of strains inhibited by a concentration of 0.03 mg/l.

Topics: 4-Quinolones; Acute Disease; Anti-Bacterial Agents; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Penicillins; Quinolines; Quinolones

Topics: 4-Quinolones; Adolescent; Adult; Anti-Infective Agents; Drug Evaluation; Female; Gonorrhea; Humans; Male; Penicillin Resistance; Quinolines; Quinolones; Urethritis

A comparative study of the new antibacterial agent, rosoxacin, a quinoline derivative, with spectinomycin was made in women with uncomplicated cervical, urethral, pharyngeal, and rectal gonorrhoea. Rosoxacin was given in three oral regimens: 200 mg in a single dose, 300 mg in a single dose, and 300 mg in two doses of 150 mg four hours apart. All culture results 72 hours after administration were negative for Neisseria gonorrhoeae in all 81 women compared with 107 of 109 who received 2 g spectinomycin intramuscularly. Thirty-five of the women successfully treated with rosoxacin harboured penicillinase-producing strains of N gonorrhoeae (PPNG) and 46 non-penicillinase-producing (non-PPNG) strains. Fifty of the women treated with spectinomycin had PPNG strains and 59 non-PPNG strains. Mild self-limiting side effects, principally dizziness, occurred in varying frequency with rosoxacin, but these were difficult to evaluate owing to the characteristics of the patient population and the conditions under which the study was conducted.

Topics: 4-Quinolones; Administration, Oral; Adolescent; Adult; Anti-Infective Agents; Drug Evaluation; Drug Tolerance; Female; Gonorrhea; Humans; Quinolines; Quinolones; Spectinomycin

61 patients, male and female, with uncomplicated acute gonorrhea were given a single dose of 300 mg rosoxacin (2 capsules). 52 patients only completed clinical and laboratory controls. The drop-out rate for follow-up examinations was 14.8%. 98% of patients were cured. One patient failed to respond to treatment, and six had reinfection seven days later at follow-up control. Three of these were again treated with rosoxacin and cured. Among the side-effects, which were recorded in 24.4% of patients, dizziness was most prevalent (18.1%). Rosoxacin is particularly valuable in gonorrhea, given the single oral dose, the absence of resistance and the high percentage of efficacy.

Topics: 4-Quinolones; Acute Disease; Adolescent; Adult; Anti-Infective Agents; Drug Administration Schedule; Female; Gonorrhea; Humans; Male; Middle Aged; Quinolines; Quinolones

A study of the new anti-bacterial agent, rosoxacin, a quinoline derivative was made in male subjects with uncomplicated acute gonorrhoea using a single oral dose of 200 mg and a single dose of 300 mg. Of the eight patients who received a single dose of 200 mg, post-treatment urethral smears and cultures for N. gonorrhoeae were positive in all and these subjects were considered as treatment failures. In contrast, a single dose of 300 mg was highly effective as all twenty-four who received this dose were cured as judged by negative urethral smears and cultures on the 7th post-treatment day. Of the thirty-eight isolates of M. gonorrhoeae obtained in the study, fifteen (39.5%) were penicillinase-producing, indicating that rosoxacin is effective in treating penicillin-resistant gonorrhoea. Mild to moderate dizziness and/or drowsiness was experienced by four of twenty-nine patients evaluated for safety on the 300 mg single dose, giving an incidence of side-effects of 14%. The symptoms were of brief duration and were self-limiting. A single oral dose of this drug appears to be an ideal treatment for the rapid cure of acute gonorrhoea.

Topics: 4-Quinolones; Acute Disease; Administration, Oral; Adult; Anti-Bacterial Agents; Dose-Response Relationship, Drug; Drug Resistance, Microbial; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Neisseria gonorrhoeae; Prostatitis; Quinolines; Quinolones

The results of this open multicenter trial with 100 patients of both sexes show that a single 300-mg dose of rosoxacin (Win 35,213) was effective in achieving a 94% cure rate, both clinical and bacteriological, on the seventh day after treatment in patients with uncomplicated acute gonococcal infection. The cure rate in men was 94% (86/92) and in women 100% (8/8). All isolates of Neisseria gonorrhoeae were susceptible to rosoxacin, as determined by 5-micrograms sensitivity disks. Adverse effects were seen in 14 patients--13 men and one woman. Twelve patients reported dizziness, one drowsiness, and one visual changes. It is concluded that rosoxacin can be of great usefulness in the epidemiological control of acute gonococcal infection, because of the lack of in vitro resistance to it, its minimal adverse effects, the low dose requirements, and the effectiveness of a single dose. The drug does not appear to have any treponemicidal action.

Topics: 4-Quinolones; Adult; Anti-Infective Agents; Female; Gonorrhea; Humans; Male; Quinolines; Quinolones; Time Factors

Topics: 4-Quinolones; Adult; Anti-Bacterial Agents; Anti-Infective Agents; Drug Resistance, Microbial; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Penicillin Resistance; Quinolines; Quinolones

Topics: 4-Quinolones; Anti-Infective Agents; Gonorrhea; Humans; Quinolines; Quinolones; Singapore