Treatment of Uncomplicated Gonorrhea in Women with a Single Oral Dose of Amoxicillin

Abstract

Amoxicillin was used to treat acute uncomplicated gonorrhea; 89 women were given a single oral dose of either 3.0 g of amoxicillin or 2.0 g of amoxicillin plus 0.5 g of probenecid. The cervix, pharynx, and rectum of each patient were cultured, and the patients were asked to return for follow-up visits after three to five and seven to 10 days, when all three sites were again cultured. There was at least one follow-up examination on 82 of the 89 patients. The failure rate in patients denying reexposure to gonorrhea were 4.6% in those treated with the 3-g regimen and 10.5% in those receiving the 2-g regimen with probenecid. There were also three patients in each treatment group in whom the reisolations of gonococci at follow-up were felt to be due to reexposure to gonorrhea. Although 40% initially had positive rectal cultures, there were no failures at the rectal site. In contrast, two of four patients with pharyngeal gonorrhea were failures. It is concluded that the two single-dose oral regimens of amoxicillin are adequate therapy for uncomplicated genital and rectal gonorrhea in women but may not be adequate for pharyngeal gonorrhea. Amoxicillin has an antibacterial spectrum comparable to that of ampicillin [1]. The superior oral absorption of amoxicillin [2, 3] might allow oral treatment regimens for uncomplicated gonorrhea at least as effective as established single-dose oral ampicillin regimens. Possibly, the inconvenience and minor side effects of high-dose oral ampicillin regimens might be ameliorated by using lower doses of amoxicillin to achieve comparable serum levels of antibiotic. We decided to test the efficacy