Gonorrhoea In Men Research Articles

Diagnostic treatment and reporting criteria for gonorrhoea in sexually transmitted disease clinics in England and Wales. 2: treatment and reporting criteria.

The current methods of treatment and reporting are described. The most common form of treatment for gonorrhoea in men and women was a single dose of oral ampicillin, usually 2 g. In proportionately more of the clinics treating women, treatment was given over several days. The wide use of ampicillin represents a marked change in treatment practice during the last decade. Procaine penicillin was the most commonly used parenteral preparation. The two dosages used most often for men were 1.2 and 2.4 megaunits. In women the commonest regimen was 2.4 megaunits and again there was a tendency for treatment to be given over several days. Epidemiology treatment was used widely and in one-third of clinics this occurred without confirmation that the patient was a true contact. Consultants used varying diagnoses on the quarterly returns for patients treated epidemiologically in whom the smears and/or cultures were negative. Most clinics classified these cases as 'other conditions requiring treatment' (D2) but as many as 19% of clinics designated these cases as being 'true' gonorrhoea. It is suggested that this results in an overestimate of the number of cases of 'real' gonorrhoea treated in England and Wales.

Asymptomatic gonorrhea in men: caused by gonococci with unique nutritional requirements.

In a retrospective case-control study, gonococci with nutritional requirements for arginine, hypoxanthine, and uracil were recovered from 24 of 25 men with asymptomatic gonorrhea and 10 of 25 men with symptomatic gonorrhea (P = .0001). These strains represent a smaller proportion of gonococcal isolate from blacks than from whites. Asymptomatic urethral infection is important in the epidemiology of gonorrhea, particularly among whites.

Oral talampicillin in the treatment of gonorrhoea.

Talampicillin was effective in eradicating the causitive organism in uncomplicated gonorrhoea, with only four treatment failures (1-6%) in 245 patients seen at least once after treatment. Symptoms, such as discharge, were seen in 61 patients at some stage after treatment but 31 of these cases were clear after one or two follow-up visits. The anitbiotic was well tolerated. One patient developed a maculopapular rash, penicillin allergy was reported in two patients, and a generalised itch (possibly penicillin allergy) in one further patient. A total of 241 out of 245 (98%) cases had the urethral gonococcus successfully eradicated with talampicillin. Talampicillin given in single doses appears to be an extremely good choice of antibiotic in the treatment of uncomplicated gonorrhoea in men.

Gonorrhoea in the asymptomatic patient: presentation and the role of contact tracing for heterosexual men and women and for homosexual men.

Clinically silent gonorrhoea is the major problem in the control of the disease. Only 12 per cent of infected women reported in 1974 because of symptoms, compared with 97 per cent of infected heterosexual men and only 35 per cent of homosexual men with gonococcal proctitis alone. Homosexual men, compared with heterosexual men, had twice as many subsequent sexual contacts after infection and had a higher incidence of early syphilis. Eighty-four per cent had experienced passive anorectal intercourse. Ninety-seven per cent of men with gonococcal urethritis reported because of symptoms, but occasionally (particularly after unsuccessful treatment) urethral gonorrhoea in men may be clinically silent and even require tests of the overnight urethral secretion for diagnosis. For women, and for homosexual men who have had passive anorectal (or oral) intercourse, the indication for attendance for tests for gonorrhoea should be having run the risk, and not the presence of symptoms. Routine tests of the anorectum for gonorrhoea are essential in cases of 80 women at risk, and for most homosexual men since over 80 per cent of these men will have had passive anorectal intercourse. Because gonococcal infections following treatment-failure are often clinically silent in both women and men, symptoms cannot be relied upon to indicate such failure. Follow-up smears and cultures are always essential.

Asymptomatic Gonorrhoea in Men

Asymptomatic Gonorrhoea in Men

Editorial: The nondiscriminant gonococcus.

Liberated or not, no woman is flattered by the notion that women are the only carriers of covert gonorrheal infection. Nor is she pleased by the thoroughness with which public health agencies trace female contacts of infected men, as contrasted with their laissez-faire in tracking down male contacts of infected women. Her pride is not readily placated by the plausible explanation that because gonorrhea in men is always floridly overt, infected men will seek medical attention of their own accord. How valid is this explanation? Can men be exonerated from harboring covert gonorrheal infection? Studies in the Norfolk Venereal Disease Clinic 1,2 demonstrated that about 10% of men exposed to infected women harbored Neisseria gonorrheae in their urethras without manifesting any symptoms. In 8.3%, the organisms persisted from 8 to 56 days after exposure. None would have known that he was a reservoir of infectious organisms—a danger to himself and

Asymptomatic Gonorrhea in Men

Asymptomatic Gonorrhea in Men

Asymptomatic gonorrhea in men: H. H. Handsfield, T. O. Lipman, J. P. Harnisch, E. Tronca, and K. K. Holmes ( 290: 117, 1974)

Asymptomatic gonorrhea in men: H. H. Handsfield, T. O. Lipman, J. P. Harnisch, E. Tronca, and K. K. Holmes ( 290: 117, 1974)

Asymptomatic gonorrhea in men. Diagnosis, natural course, prevalence and significance.

Abstract Urethral gonococcal infection was detected in 40 per cent of asymptomatic male contacts of women with symptomatic gonorrhea. Culture was more sensitive than fluorescent antibody or Gram-stained smears in detecting asymptomatic genital infection in men, and Neisseria gonorrhoeae was detected more often in the anterior urethra than in prostatic secretions by all three methods. Among 28 asymptomatically infected men followed without treatment for seven to 165 days, 18 remained asymptomatic carriers of N. gonorrhoeae. N. gonorrhoeae was cultured from 59 (2.2 per cent) of 2628 sexually active United States Army enlisted men undergoing routine examinations, and 68 per cent of the infected men were asymptomatic. Asymptomatically infected men constitute a definite reservoir of N. gonorrhoeae, and a major factor in the current gonorrhea pandemic is the failure of physicians to identify and treat asymptomatic male contacts of women with gonorrhea that is either symptomatic or detected by routine culturing....

Single-dose oral treatment of gonorrhea in men and women, using ampicillin alone and combined with probenecid.

Single-dose oral treatment of gonorrhea in men and women, using ampicillin alone and combined with probenecid.

Sensitivity and reproducibility of Thayer-Martin culture medium in diagnosing gonorrhea in women

The Thayer-Martin culture medium was evaluated by culturing specimens from the cervix and rectum of 59 women alleged to have been the source of gonorrhea in men. By testing these women on 3 consecutive days, 50 (85 per cent) were culturally confirmed to have gonorrhea. A single cervical culture detected 89.7 per cent of those infected; repeating a single cervical culture on a subsequent day resulted in a total detection of 96.6 per cent of those infected. The remaining 3.4 per cent in the detection rate was achieved by a single rectal culture. Reproducibility of positive results occurred in 91 per cent of 266 cervical specimens and 89 per cent of 165 rectal specimens. The Thayer-Martin culture medium provides an accurate and reliable means of detecting gonorrhea in women, and its use should be considered for routine screening of high-risk populations.

Effect of Double Dose of Aqueous Procaine Penicillin to Treat Gonorrhea in Men

AN earlier study at the Alameda County Health ,A Department venereal disease clinic, Oakland, Calif., indicated that gonorrhea can still be treated effectively by a single intramuscular injection of a sufficiently large dose of rapidly acting penicillin (1). In the men observed in that study, the single intramuscular injection of 2.4 million units of aqueous procaine penicillin G (APP) recommended by the Food and Drug Administration and the Public Health Service (2) and subsequently adopted by the joint U.S. military forces (3) was not always sufficient to eliminate Neisseria gonorrhoeae, presumably because some strains were relatively penicillin resistant. For women, however, doubling the dose to 4.8 million units injected intramuscularly at one session cured the entire group, and it was hypothesized that the cure rate might be similarly raised in men if the dose were doubled. The present study tested this hypothesis in 830 men treated alternatively with either the 2.4or 4.8-million-unit \PP regimen from March 12, 1969, to October 7, 1969. (The Alameda County Health Department venereal disease clinic is located in Oakland, Calif., a port of debarkation from Vietnam. Gonorrhea acquired by U.S. servicemen in the Far East, particularly in Vietnam, has been reported often as resistant to treatment (4-6). Presumably, therefore, many resistant strains of N. gonorrhoeae should have been encountered in this series).

Six-city study of treatment of gonorrhoea in men using single oral doses of 1.5 or 3 g. tetracycline hydrochloride.

Six-city study of treatment of gonorrhoea in men using single oral doses of 1.5 or 3 g. tetracycline hydrochloride.

Studies of venereal disease. II. Observations on the incidence, etiology, and treatment of the postgonococcal urethritis syndrome.

Postgonococcal urethritis (PGU) occurred in nearly two thirds of men with gonorrhea acquired in the Far East who were successfully treated with 2,400,000 units of procaine penicillin G plus probenecid. PGU occurred less often after treatment of gonorrhea with tetracycline hydrochloride, and PGU itself responded to tetracycline, suggesting a microbial etiology for the condition. The syndrome was associated to a highly significant degree withMycoplasmainfection of the urethra, and occurred more often after infection with Neisseriagonorrhoeaeof lessened penicillin sensitivity. The high incidence of the syndrome, one of the most common infectious diseases among military personnel in the Far East, requires a reexamination of the traditional use of penicillin in the treatment of gonorrhea in men.

Studies of Venereal Disease

Postgonococcal urethritis (PGU) occurred in nearly two thirds of men with gonorrhea acquired in the Far East who were "successfully" treated with 2,400,000 units of procaine penicillin G plus probenecid. PGU occurred less often after treatment of gonorrhea with tetracycline hydrochloride, and PGU itself responded to tetracycline, suggesting a microbial etiology for the condition. The syndrome was associated to a highly significant degree with<i>Mycoplasma</i>infection of the urethra, and occurred more often after infection with Neisseria<i>gonorrhoeae</i>of lessened penicillin sensitivity. The high incidence of the syndrome, one of the most common infectious diseases among military personnel in the Far East, requires a reexamination of the traditional use of penicillin in the treatment of gonorrhea in men.

Studies of Venereal Disease

Treatment of gonorrhea in men with a single intramuscular dose of 2,400,000 units of procaine penicillin G, recommended by the US Public Health Service and the armed forces in 1965, continues to result in 20% to 30% treatment failures among military personnel in the Far East. In studies of confined populations aboard air-craft carriers, 63 men with gonorrhea received 2,400,000 units of procaine penicillin G with 18 (29%) treatment failures; 58 men received 2,400,000 units procaine penicillin Gplus probenecidorally, with only one failure. Resistance to 0.06 units of penicillin per milliliter of medium was noted in 26 of 41 (63%) and 57 of 74 (77%)Neisseria gonorrhoeaeisolates from the respective groups. Thirty men received tetracycline hydrochloride orally, with no failures. In areas where treatment of gonorrhea with large parenteral doses of penicillin G is becoming less effective, adequate therapy is possible with probenecid plus penicillin or with tetracycline.

Recent Clinicolaboratory Observations in the Treatment of Acute Gonococcal Urethritis in Men

Diagnosis of acute gonorrhea was made for 350 male inmates who were treated in a controlled clinicolaboratory program using four antibiotic schemata. Low failure rates, 1.8% and 2.1%, respectively, were observed with oxytetracycline therapy and procaine penicillin G, 2.4 million units, administered immediately. Procaine penicillin G in four daily doses of 600,000 units yielded 3.7% failures. Repository penicillin, 2.4 million units, administered immediately, increased treatment failures to 5.9%. Nonspecific urethritis sequelae were markedly diminished with the oxytetracycline regimen. In vitro observations revealed all gonococci strains studied were sensitive to penicillin and oxytetracycline despite occasional in vivo treatment failures. Treatment failure rates indicate the need to resurvey gonorrhea therapy at periodic intervals. Organisms of the tribe Mimeae were not encountered in this study; until substantive evidence is offered this group should be eliminated from further serious consideration in gonorrhea in men.

Clinicolaboratory study of acute gonorrhea in men in the El Paso, Tex, area.

Resistance to penicillin has become an important factor in the epidemiology of gonorrhea. Among military personnel stationed in the El Paso area, the finding of resistance in vitro was seen to be correlated with poor clinical outcome. No failures followed initial treatment with 2.5 million units. But when 1.0 million units of procaine penicillin G, or 600,000 of both procaine plus benzathine penicillin, were used, 15% failed. Further inquiry disclosed that these failures involved organisms having a minimal inhibitory concentration of 0.10 unit/ml or greater. Although sought for, no organism of the tribe Mimea was isolated during this study; this was curious because a number of these men had earlier been stationed in the Far East and Europe where such organisms have been reported frequently.

Fluorescent Antibody Tests for Detection of the Gonococcus in Women

THE successful application of the fluorescent antibody (FA) method for the identification of Neis8eria gonorrhoeae in men prompted an investigation of the use of this method for the detection of gonococcus in women. The preparation and use of fluorescein-labeled antiserums for the detection of the gonococcus in

PENICILLIN TREATMENT OF SULFA-RESISTANT GONORRHEA; RESULTS OF 500 CASES TREATED WITH 50,000 UNITS OF PENICILLIN

Article1 June 1945PENICILLIN TREATMENT OF SULFA-RESISTANT GONORRHEA; RESULTS OF 500 CASES TREATED WITH 50,000 UNITS OF PENICILLINALLEN I. JOSEY, FORREST E. KIRSHMANALLEN I. JOSEYSearch for more papers by this author, FORREST E. KIRSHMANSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-22-6-807 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring the early observation of the effects of penicillin on various organisms the gonococcus was found to be susceptible, and during 1943 its successful use in several small series of cases was reported.1, 2, 3Recently Ferguson and Buckholtz,4in reporting the results of treatment in 735 cases of sulfonamide resistant gonorrhea with varying doses of penicillin, indicated that a dosage of at least 100,000 Oxford units was necessary for uniformly satisfactory results. During the summer of 1943 O'Reilly General Hospital, among a number of other general hospitals, was assigned the task of treating several groups of sulfa-resistant gonorrhea with...Bibliography1. RICHARDS AN: Penicillin—Statement Released by Committee on Medical Research, Jr. Am. Med. Assoc., 1943, cxxii, 235. Google Scholar2. HERRELLCOOKTHOMPSON WEENL: Use of penicillin in sulfonamide resistant gonorrheal infections, Jr. Am. Med. Assoc., 1943, cxxii, 289. CrossrefGoogle Scholar3. Keefer CS Blake FG Marshall EK Lockwood JS Wood WB Penicillin in the Treatment of Infections: Statement by the Committee on Chemotherapeutic and Other Agents, Division of Medical Sciences, National Research Council, , Boston, Chairman; , New Haven, Conn.; , Baltimore; , Philadelphia and , St. Louis, Jr. Am. Med. Assoc., 1943, cxxii, 1217. CrossrefGoogle Scholar4. FERGUSONBUCKHOLTZ CM: Penicillin therapy of gonorrhea in men, Jr. Am. Med. Assoc., 1944, cxxv, 23. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication August 29, 1944.From the Medical Service, O'Reilly General Hospital. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTHERAPY OF GONOCOCCAL ARTHRITIS*PAUL O. HAGEMANN, M.D., F.A.C.P., AARON HENDIN, M.D., HAROLD H. LURIE, M.D., MARVIN STEIN, M.D. 1 June 1945Volume 22, Issue 6Page: 807-810KeywordsGonorrheaMedical servicesNeisseria gonorrhoeaePenicillinSulfonamide ePublished: 1 December 2008 Issue Published: 1 June 1945 PDF downloadLoading ...