Skip to main content
PMC home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1989 Feb;33(2):167–170. doi: 10.1128/aac.33.2.167

Multicenter randomized study of single-dose ofloxacin versus amoxicillin-probenecid for treatment of uncomplicated gonococcal infection.

J R Black 1, J M Long 1, B E Zwickl 1, B S Ray 1, M S Verdon 1, S Wetherby 1, E W Hook 3rd 1, H H Handsfield 1
PMCID: PMC171450  PMID: 2719459

Abstract

The safety and efficacy of ofloxacin, 400 mg orally, were compared with those of amoxicillin, 3.0 g, plus probenecid, 1.0 g orally, as single-dose therapy in 201 heterosexual patients (101 men and 100 women) with uncomplicated gonococcal infection. Treatment groups were comparable in age, duration of symptoms, number of sexual partners within the previous month, and number of previous episodes of sexually transmitted diseases. The cure rate for men treated with ofloxacin was 98% (47 of 48), and that for women was 100% (52 of 52). Cure rates for both men and women treated with amoxicillin-probenecid were 96% (51 of 53 men; 46 of 48 women). All 13 patients with positive rectal cultures and 7 of 8 patients with positive pharyngeal cultures treated with ofloxacin were cured. Neither regimen reliably eradicated coexistent infection with Chlamydia trachomatis. The MIC of ofloxacin for all but two of 198 pretreatment isolates was 0.3 microgram/ml or less. The MIC of amoxicillin for 90% of isolates tested was 1.0 microgram/ml. Single oral doses of ofloxacin and of amoxicillin plus probenecid were equally effective for treatment of urethral and cervical gonorrhea. Ofloxacin appears promising as treatment for rectal and pharyngeal infection, but studies with larger numbers of patients with rectal or pharyngeal infection or both are required for confirmation. Relative contraindications in children and possibly pregnant women plus the potential for single-step, high-level resistance may limit the usefulness of quinolone therapy for gonorrhea.

Full text

PDF
167

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Elwell L. P., Roberts M., Mayer L. W., Falkow S. Plasmid-mediated beta-lactamase production in Neisseria gonorrhoeae. Antimicrob Agents Chemother. 1977 Mar;11(3):528–533. doi: 10.1128/aac.11.3.528. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Faruki H., Kohmescher R. N., McKinney W. P., Sparling P. F. A community-based outbreak of infection with penicillin-resistant Neisseria gonorrhoeae not producing penicillinase (chromosomally mediated resistance). N Engl J Med. 1985 Sep 5;313(10):607–611. doi: 10.1056/NEJM198509053131004. [DOI] [PubMed] [Google Scholar]
  3. Jones R. B., Rabinovitch R. A., Katz B. P., Batteiger B. E., Quinn T. S., Terho P., Lapworth M. A. Chlamydia trachomatis in the pharynx and rectum of heterosexual patients at risk for genital infection. Ann Intern Med. 1985 Jun;102(6):757–762. doi: 10.7326/0003-4819-102-6-757. [DOI] [PubMed] [Google Scholar]
  4. KELLOGG D. S., Jr, PEACOCK W. L., Jr, DEACON W. E., BROWN L., PIRKLE D. I. NEISSERIA GONORRHOEAE. I. VIRULENCE GENETICALLY LINKED TO CLONAL VARIATION. J Bacteriol. 1963 Jun;85:1274–1279. doi: 10.1128/jb.85.6.1274-1279.1963. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Kaplowitz L. G., Vishniavsky N., Evans T., Vartivarian S., Dalton H., Simpson M., Gruninger R. P. Norfloxacin in the treatment of uncomplicated gonococcal infections. Am J Med. 1987 Jun 26;82(6B):35–39. doi: 10.1016/0002-9343(87)90616-4. [DOI] [PubMed] [Google Scholar]
  6. Laughon B. E., Ehret J. M., Tanino T. T., Van der Pol B., Handsfield H. H., Jones R. B., Judson F. N., Hook E. W., 3rd Fluorescent monoclonal antibody for confirmation of Neisseria gonorrhoeae cultures. J Clin Microbiol. 1987 Dec;25(12):2388–2390. doi: 10.1128/jcm.25.12.2388-2390.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Lockley M. R., Wise R., Dent J. The pharmacokinetics and tissue penetration of ofloxacin. J Antimicrob Chemother. 1984 Dec;14(6):647–652. doi: 10.1093/jac/14.6.647. [DOI] [PubMed] [Google Scholar]
  8. Morse S. A., Johnson S. R., Biddle J. W., Roberts M. C. High-level tetracycline resistance in Neisseria gonorrhoeae is result of acquisition of streptococcal tetM determinant. Antimicrob Agents Chemother. 1986 Nov;30(5):664–670. doi: 10.1128/aac.30.5.664. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Norden C. W., Niederriter K. Ofloxacin therapy for experimental osteomyelitis caused by Pseudomonas aeruginosa. J Infect Dis. 1987 Apr;155(4):823–825. doi: 10.1093/infdis/155.4.823. [DOI] [PubMed] [Google Scholar]
  10. Rajakumar M. K., Ngeow Y. F., Khor B. S., Lim K. F. Ofloxacin, a new quinolone for the treatment of gonorrhea. Sex Transm Dis. 1988 Jan-Mar;15(1):25–26. doi: 10.1097/00007435-198801000-00005. [DOI] [PubMed] [Google Scholar]
  11. Roddy R. E., Handsfield H. H., Hook E. W., 3rd Comparative trial of single-dose ciprofloxacin and ampicillin plus probenecid for treatment of gonococcal urethritis in men. Antimicrob Agents Chemother. 1986 Aug;30(2):267–269. doi: 10.1128/aac.30.2.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Sato K., Matsuura Y., Inoue M., Une T., Osada Y., Ogawa H., Mitsuhashi S. In vitro and in vivo activity of DL-8280, a new oxazine derivative. Antimicrob Agents Chemother. 1982 Oct;22(4):548–553. doi: 10.1128/aac.22.4.548. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Thornsberry C., Kirven L. A. Ampicillin resistance in Haemophilus influenzae as determined by a rapid test for beta-lactamase production. Antimicrob Agents Chemother. 1974 Nov;6(5):653–654. doi: 10.1128/aac.6.5.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Veller-Fornasa C., Tarantello M., Cipriani R., Guerra L., Peserico A. Effect of ofloxacin on Treponema pallidum in incubating experimental syphilis. Genitourin Med. 1987 Jun;63(3):214–214. doi: 10.1136/sti.63.3.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Vera H. D. A Simple Medium for Identification and Maintenance of the Gonococcus and Other Bacteria. J Bacteriol. 1948 Apr;55(4):531–536. doi: 10.1128/jb.55.4.531-536.1948. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Welborn P. P., Uyeda C. T., Ellison-Birang N. Evaluation of Gonochek-II as a rapid identification system for pathogenic Neisseria species. J Clin Microbiol. 1984 Oct;20(4):680–683. doi: 10.1128/jcm.20.4.680-683.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Zenilman J. M., Bonner M., Sharp K. L., Rabb J. A., Alexander E. R. Penicillinase-producing Neisseria gonorrhoeae in Dade County, Florida: evidence of core-group transmitters and the impact of illicit antibiotics. Sex Transm Dis. 1988 Jan-Mar;15(1):45–50. doi: 10.1097/00007435-198801000-00011. [DOI] [PubMed] [Google Scholar]
  18. van der Willigen A. H., van der Hoek J. C., Wagenvoort J. H., van Vliet H. J., van Klingeren B., Schalla W. O., Knapp J. S., van Joost T., Michel M. F., Stolz E. Comparative double-blind study of 200- and 400-mg enoxacin given orally in the treatment of acute uncomplicated urethral gonorrhea in males. Antimicrob Agents Chemother. 1987 Apr;31(4):535–538. doi: 10.1128/aac.31.4.535. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES