RESUMO
A trial comparing the efficacy of three different tetracyclines, each in two different dosage regimens, in the treatment of non-specific urethritis is described. There was a significant association between the retreatment rate and sexual intercourse. Age, race, duration of symptoms, previous infection, and indulgence in alcohol did not appear to influence the results whereas treatment of sexual contacts before resumption of sexual intercourse significantly reduced the retreatment rate. Single-dose treatment with doxycycline was shown to be ineffective. Treatment with doxycycline for seven days or triple tetracycline for seven days was less effective than triple tetracycline for 21 days or oxytetracyline for seven or 21 days, all of which gave the same success rate.
Assuntos
Tetraciclinas/uso terapêutico , Uretrite/tratamento farmacológico , Adulto , Consumo de Bebidas Alcoólicas , Coito , Doxiciclina/uso terapêutico , Esquema de Medicação , Humanos , Masculino , Pessoa de Meia-Idade , Oxitetraciclina/uso terapêutico , Tetraciclina/uso terapêutico , Tetraciclinas/administração & dosagemRESUMO
The epidemiological features are described of an outbreak of gonorrhoea caused by penicillinase-producing strains of gonococci in 76 patients in Liverpool between February and November 1976. Initially infections were confined to a socially deprived inner city area with a large immigrant population, and subsequent spread of infection remained circumscribed. The characteristics of those patients acquiring these infections were similar to those infected by gonococci of diminished sensitivity to benzylpenicillin, and showed a strong association with adverse social factors. A comparison of the clinical features of patients harbouring sensitive, less sensitive, and penicillinase-producing strains showed severe symptoms and signs in men and a greater involvement of multiple sites in women infected with penicillinase-producing gonococci. Treatment with penicillins failed. Tetracycline was satisfactory in men but was less so in women in whom gonococci persisted in the rectum. Cefuroxime and spectinomycin were effective.
Assuntos
Surtos de Doenças/epidemiologia , Gonorreia/tratamento farmacológico , Gonorreia/epidemiologia , Negro ou Afro-Americano , Antibacterianos/uso terapêutico , População Negra , Inglaterra , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Neisseria gonorrhoeae/enzimologia , Penicilinase/biossíntese , Características de ResidênciaRESUMO
Gonococci, which had acquired a TEM-type of penicillinase widely distributed among gram-negative bacilli, appeared in February, 1976, and soon accounted for 9% of isolates at a clinic in Liverpool. In 45 patients infected by such gonococci, the frequency of complications did not suggest reduced communicability or invasiveness, and usual forms of treatment with penicillins always failed. Spectinomycin succeeded in 21 (95%) of 22 patients treated, blt tetracyclines succeeded in only 13 (68%) of 19. Appropriate laboratory tests for recognising penicillinase-producing gonococci must be used since such gonococci have already been transferred to other parts of the U.K. Penicillinase-stable cephalosporins were active in vitro and could prove to be the future treatment of choice.
