tetracycline and Proctitis

Topics: Anti-Infective Agents; Arthritis, Infectious; Cephalosporins; Child; Doxycycline; Erythromycin; Female; Gonorrhea; Humans; Kanamycin; Leucomycins; Male; Ophthalmia Neonatorum; Penicillins; Proctitis; Salpingitis; Sexually Transmitted Diseases; Spectinomycin; Sulfonamides; Tetracycline; Thiamphenicol; Trimethoprim

Topics: Female; Humans; Infant, Newborn; Lymphogranuloma Venereum; Male; Pregnancy; Proctitis; Salpingitis; Tetracycline; Urethritis

Of the currently recommended regimens for treatment of uncomplicated gonorrhea, only aqueous penicillin G procaine is effective against infections at all sites. However, procaine penicillin is not effective against penicillinase-producing Neisseria gonorrhoeae and suffers from poor patient acceptability owing to the 10-mL volume of injection and allergic and toxic procaine reactions. Ceftriaxone is a new extended-spectrum cephalosporin with a long serum half-life and is many times more active than penicillin G against both beta-lactamase-positive or -negative strains of N gonorrhoeae. Ceftriaxone was compared as a single, 125-mg, 0.5-mL injection with a single 2-g injection of spectinomycin in difficult to treat pharyngeal gonorrhea in men and women and anorectal gonorrhea of men. Ceftriaxone cured 30/32 (94%) pharyngeal and 52/52 anorectal infections, compared with 6/14 (43%) and 9/9, respectively, for spectinomycin. Both regimens were well tolerated. Ceftriaxone may prove to be a drug of choice for uncomplicated gonorrhea, particularly where homosexual men are treated and/or penicillinase-producing N gonorrhoeae is prevalent.

Topics: Adult; Cefotaxime; Ceftriaxone; Clinical Trials as Topic; Drug Eruptions; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Penicillin G; Pharyngitis; Proctitis; Spectinomycin; Tetracycline

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Homosexuality; Humans; Male; Proctitis; Tetracycline

The records of 1,381 patients with gonorrhea were examined by the Massachusetts Department of Public Health to determine the efficacy of their treatment schedules. Urethritis, cervicitis and pharyngitis were treated with 4.8 million u. of aqueous procaine penicillin G intramuscularly, without probenecid. Cure rates were 98 percent in urethritis, 97 percent in pharyngitis and 98 percent in cervicitis. Patients allergic to penicillin were treated with tetracycline orally or spectinomycin intramuscularly. In patients with proctitis, a 98 percent cure rate was achieved with one intramuscular injection of procaine penicillin G, followed by ampicillin orally for four days.

Topics: Adult; Ampicillin; Drug Administration Schedule; Female; Gonorrhea; Humans; Male; Pelvic Inflammatory Disease; Penicillin G Procaine; Penicillin Resistance; Pharyngitis; Proctitis; Spectinomycin; Tetracycline; Urethritis; Uterine Cervicitis

In a prospective investigation of rectal gonorrhea in men, 1262 patients were studied on the basis of rectal symptoms, gonorrhea contact, or a previously positive rectal culture for Neisseria gonorrhoeae. Five hundred fifty-four patients (44%) had rectal gonorrhea, based on a positive culture; in these patients the symptom of mucus on the stool and the anoscopic finding of generalized exudate proved significant but of low specificity when compared with symptoms and findings in culture-negative patients. Patients were treated with either 4.8 million units of procaine penicillin with 1 g probenecid, 3.5 or 4.5 g of ampicillin with 1 g probenecid, or 9.5 g of tetracycline given over 4 days. Four hundred seven patients with rectal gonorrhea returned for test of cure. Failure rates were 5% with each of the first three regimens and 15% with tetracycline (P less than 3.31). Procaine penicillin with probenecid is recommended as the treatment of choice, with tetracycline being reserved for penicillin-allergic patients.

Topics: Ampicillin; Drug Therapy, Combination; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Penicillin G Procaine; Probenecid; Proctitis; Proctoscopy; Prospective Studies; Tetracycline

The worldwide increase in the incidence of sexually transmitted diseases confronts the physician to an increasing extent with this group of infections. The high morbidity and the change in the clinical picture of gonorrhea, especially its asymptomatic form, give rise to extragenital complications which frequently lead the patient to the internal specialist in the first instance. Non-gonorrheal urethritis, in particular the infectious form, is undergoing intensive research. A number of organisms may be responsible, but a non-infectious origin must also be kept in mind. Syphilis is still important. The late stages of the disease have become rare thanks to highly effective therapy with antibiotics. The early stages of the infection, however, must always be considered in the differential diagnosis of any genital or anal affection, and also in generalized exanthemas of unknown origin. Homosexual transmission presents diagnostic problems of its own. Serological mass screening is essential. Interpretation of the results must take into account the different specificity of the various serological tests and their indication.

Topics: Erythromycin; Family Practice; Female; Gonorrhea; Hepatitis; Humans; Male; Neisseria gonorrhoeae; Penicillins; Proctitis; Sepsis; Sexually Transmitted Diseases; Syphilis; Tetracycline; Urethritis

Topics: Candidiasis, Vulvovaginal; Female; Gonorrhea; Humans; Male; Pelvic Inflammatory Disease; Penicillin G Procaine; Pharyngitis; Proctitis; Syphilis; Tetracycline; Urogenital System; Vulvovaginitis

Topics: Chlamydia Infections; Female; Granuloma Inguinale; Humans; Lymphogranuloma Venereum; Male; Mycoplasma Infections; Proctitis; Sexually Transmitted Diseases; Tetracycline; Urethritis; Uterine Cervicitis; Vaginitis