Penicillin-Sensitive Gonococci and Polyarthritis

Abstract

For those senior investigators who helped introduce depot penicillin into clinical practice, the article in this issue ofThe Journalby Trentham and colleagues (p 2410) on the treatment of gonococcal arthritis is particularly gratifying. When penicillin G was more expensive and intravenous therapy less routine, the demonstration of the levels in the blood achieved by injections of procaine penicillin G was of great interest, especially when such levels were far in excess of the penicillin sensitivity of such organisms as group A streptococci,Treponema pallidum, pneumococci, and gonococci.1,2 Proceeding on the assumption of the continued sensitivity of gonococci which produce bacteremia and arthritis, some of us who needed to differentiate the syndrome of gonococcal polyarthritis from acute rheumatic fever in an adolescent population in which both diseases were prevalent found that a therapeutic trial of 600,000 units of procaine penicillin G daily was very useful. Such therapy seemed