Comparative Study of Ceftriaxone and Spectinomycin for Treatment of Pharyngeal and Anorectal Gonorrhea

JAMA. 1985 Mar 8;253(10):1417-9.

Abstract

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cefotaxime / adverse effects
  • Cefotaxime / analogs & derivatives*
  • Cefotaxime / therapeutic use
  • Ceftriaxone
  • Clinical Trials as Topic
  • Drug Eruptions / etiology
  • Female
  • Gonorrhea / drug therapy*
  • Gonorrhea / microbiology
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Penicillin G / pharmacology
  • Pharyngitis / drug therapy*
  • Pharyngitis / etiology
  • Proctitis / drug therapy*
  • Proctitis / etiology
  • Spectinomycin / therapeutic use*
  • Tetracycline / pharmacology

Substances

  • Ceftriaxone
  • Spectinomycin
  • Tetracycline
  • Cefotaxime
  • Penicillin G