Clinical response of patients with gonococcal endocervicitis and endometritis-salpingitis-peritonitis to doxycycline

Abstract

The clinical response to single-drug therapy with doxycycline was evaluated in 25 patients with gonococcal endocervicitis and was correlated with the bacterial isolates present within the cul-de-sac. The 10 patients with gonococcal salpingitis and the three patients with gonococcal peritonitis exhibited excellent clinical responses. When polymicrobial infection coexisted with gonococcal peritonitis or functioned without the concomitant presence ofNeisseria gonorrhoeae, a significantly altered therapeutic response was observed in four of the 12 patients. Four patients in this grouping exhibited either secondary temperature elevations or lack of a significant alteration of the white blood cell count, two features which were not characteristic of the patients with either gonococcal salpingitis or peritonitis. In the cases of polymicrobial peritonitis, there was a poor correlation between ensuing clinical response and in vitro resistance of one or more cul-de-sac isolates to doxycycline. The presence of a resistant organism did not preclude a good or satisfactory clinical response. The absence of a resistant organism correlated well with a good clinical response.