Uncomplicated Gonococcal Urethritis In Men Research Articles

Randomized controlled clinical trial on the efficacy of fosfomycin trometamol for uncomplicated gonococcal urethritis in men

We assessed the efficacy of fosfomycin trometamol in treating uncomplicated gonococcal urethritis in men. We conducted an open randomized controlled trial in 152 consecutive men with any main complaints suggestive of uncomplicated gonococcal urethritis in Dujiangyan Medical Center between 1 September 2013 and 31 August 2015. In total, 126 patients completed all aspects of this study. Sixty were provided therapy with fosfomycin trometamol 3 g orally on days 1, 3 and 5 in the intervention group; the other 61 were provided ceftriaxone 250 mg intramuscularly plus azithromycin 1 g orally simultaneously as a single dose in the control group. The primary outcomes involved clinical and microbiologic cure on days 7 and 14 after receipt of all the study medications. At the day 7 follow-up visit, all the 121 participants had complete resolution of clinical symptoms and signs. In addition, five patients (two in the intervention group and three in the control group) discontinued intervention because of unsuccessful treatment. After receipt of all the study medications, these five patients still had urethral purulent discharge and were switched to other unknown treatment regimens by other doctors. The bacterial smears and cultures of urethral or urine specimens in the 121 patients who completed all aspects of the study were negative on a test-of-cure visit. In the per-protocol analysis, both clinical and microbiologic cure were experienced by 96.8% (60/62 patients) in the intervention group and 95.3% (61/64 patients) in the control group. There were no recurrences at the day 14 test-of-cure visit. This trial indicates that fosfomycin trometamol exhibits excellent efficacy for treatment of uncomplicated gonococcal urethritis in men. Serious adverse effects are rare.

Clinical Efficacy of Pefloxacin in Complicated Urinary Tract Infections, Uncomplicated Gonococcal Urethritis, Prostatitis and Epididymitis

This paper reviews the antibacterial in vitro activity of pefloxacin against uropathogens associated with complicated and/or hospital-acquired urinary tract infections (UTIs) and presents data from published studies investigating the therapy of complicated UTIs (including acute pyelonephritis), uncomplicated gonococcal urethritis, bacterial prostatitis, and epididymitis. Results from the published literature have demonstrated that pefloxacin is a useful treatment alternative in complicated UTIs with or without pyelonephritis, as single dose therapy in uncomplicated gonococcal urethritis in men, and in acute exacerbation of bacterial prostatitis and acute epididymitis. In a number of controlled studies investigating the efficacy and safety of pefloxacin in complicated UTI/pyelonephritis, results were similar to those with the comparator agents (ofloxacin, gentamicin or cefotaxime), although patient population sizes were not large enough to allow for the testing of equivalence according to accepted statistical methods. According to 2 dose-finding studies, it would appear desirable to investigate a once-daily regimen more closely, using either pefloxacin 800 or 400mg, considering the advantages of improved patient compliance.

Different doses of cefetamet pivoxil (Ro 15-8075) in the treatment of acute uncomplicated gonococcal urethritis in men

In an open, dose-finding study, a 100% cure rate was observed in patients suffering from uncomplicated gonococcal urethritis who were treated with a single oral dose of either 1.2 g (n = 10), 0.8 g (n = 11), or 0.4 g (n = 10) of cefetamet pivoxil. The MICs of cefetamet for all gonococcal strains ranged from 0.001 to 0.12 micrograms/ml, and the MIC for 90% of the strains tested was 0.008 micrograms/ml. Cefetamet pivoxil was ineffective against Chlamydia trachomatis in 3 of 31 patients. Side effects were minor.

Pefloxacin compared with cefotaxime for treating men with uncomplicated gonococcal urethritis

In a randomized comparative study, 83 male patients suffering from acute uncomplicated gonococcal urethritis were treated with a single dose of either 0.8 g pefloxacin, given orally, or 1.0 g cefotaxime, given intramuscularly. The cure rates were 100% in both treatment groups four to seven days and 21 to 31 days, respectively, after therapy. The MICs of the isolated Neisseria gonorrhoeae ranged from 0.008 to 0.06 mg/l for pefloxacin and from 0.0005 to 0.03 mg/l for cefotaxime. Postgonococcal urethritis was found in 9% of the patients treated with pefloxacin and in 20% of the patients treated with cefotaxime. Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum were isolated from 15%, 7% and 22% of the patients, respectively, before therapy and from 22%, 11% and 20% of the patients, respectively, 21 to 31 days after therapy. Both antibiotics had no effect on the presence of these microorganisms. No side effects were recorded in either groups of patients except that 46% of the patients treated with cefotaxime reported mild pain at the injection site. In conclusion, pefloxacin and cefotaxime are safe and effective agents in the treatment of uncomplicated gonococcal urethritis in men.

Single dose piperacillin in treating uncomplicated gonococcal urethritis in men.

A single intramuscular dose of piperacillin 2 g, with probenecid 1 g orally, was used to treat 82 men with uncomplicated gonococcal urethritis due to penicillinase producing strains of Neisseria gonorrhoeae (PPNG) or non-PPNG. All 49 patients infected with non-PPNG strains were cured, as opposed to only 25 (76%) of 33 patients infected with PPNG strains, giving an overall success rate of 90%. No serious side effects of treatment were observed. Post gonococcal urethritis (PGU) occurred in 18% of the patients treated. Antibiotic susceptibility tests showed that 44 (96%) of the 46 non-PPNG strains tested had MICs of piperacillin of 2 mg/l or less and 26 (76%) of the 34 PPNG strains had MICs of 32 mg/l or more. This regimen is not recommended for use as first line treatment in areas where there is a high incidence of infection with PPNG strains. It is, however, highly effective against non-PPNG strains.

Double-blind trial of amoxycillin and ampicillin plus probenecid in the treatment of gonorrhoea in men.

In a double-blind study amoxycillin 3 g or ampicillin 3 g plus probenecid 1 g were randomly administered as a single oral dose to 160 men with uncomplicated gonococcal urethritis. The cure rate for each drug group was 98.6%. Tolerance to oral medication was good and no evidence of allergy or toxicity to either drug was shown. No case of post-gonococcal urethritis was observed over a 14-day follow-up period. Thus, both drug regimens proved very effective in treating uncomplicated gonococcal urethritis in men.