Male urethritis in Bahrain: the increasing incidence of resistant gonorrhea

Bahrain has a relatively low incidence of male urethritis; about one-half of these cases are due to N.gonorrhoeae. Despite the overall low frequency of sexually transmitted disease in Bahrain, N. gonorrhoeae isolates are often highly resistant. One-fourth of recent strains were resistant to penicillin, and 65% of the remaining isolates showed evidence of a chromosomally mediated diminished sensitivity to penicillin. Resistance to tetracycline is not yet common, but emerging chromosomal resistance and potentially poor compliance make tetracyclines inferior agents for gonorrhea therapy. We recommend ceftriaxone as primary therapy for N.gonorrhoeae in Bahrain; spectinomycin would be a reasonable second choice

Urinary tract infections in Bahrain: what is the drug of choice?

Choosing appropriate and cost effective antibiotics to treat common infections like those of the urinary tract is an important aspect of a Physician's work. Making the right choice requires knowledge of local isolates. In Bahrain, most urinary infections are due to gram negative organisms, mainly E. coli and klebsiella species. Resistance to ampicillin and carbenicillin is now so widespread as to make these agents useless for empiric therapy. Gentamicin, cotrimoxazole cephalosporins and quinolines are all useful in selected circumstances. For serious infections requiring parenteral therapy, gentamicin is preferred, with ampicillin added if enterococcal infection is likely. Cotrimoxazole or a quinolone is adequate for pyelonephritis if the patient can tolerate oral therapy; these oral agents are also excellent for lower tract disease