Spectinomycin hydrochloride in the treatment of gonorrhoea: Its effect on associated Chlamydia trachomatis infections.

Sixty-three heterosexual men were successfully treated with a single injection of spectinomycin hydrochloride 2 g for urethral infections with Neisseria gonorrhoeae. Chlamydia trachomatis was recovered from the urethra of 11 of these men both before and after treatment. In six men, the organism was isolated after but not before treatment. No isolates were obtained from the remaining men either before or after treatment. All 17 of the men who yielded C. trachomatis developed post-gonococcal urethritis. Eight of 46 men from whom no isolate was obtained in their cultures developed post-gonococcal urethritis. Seventeen of 50 women successfully treated with spectinomycin for cervical infections with N. gonorrhoeae yielded isolates of C. trachomatis both before and after treatment. The organism was isolated from five women before but not after treatment, and from four women after but not before treatment. In 24 women culture for C. trachomatis was negative both before and after treatment. Spectinomycin hydrochloride in the dosage used rarely eliminated C. trachomatis from the genital tract of either men or women; in this respect it resembled two other drugs commonly used for the treatment of gonorrhoea-pencillin and ampicillin.     

Spectinomycin hydrochloride in the treatment of gonorrhoea: Its effect on associated Chlamydia trachomatis infections.

Sixty-three heterosexual men were successfully treated with a single injection of spectinomycin hydrochloride 2 g for urethral infections with Neisseria gonorrhoeae. Chlamydia trachomatis was recovered from the urethra of 11 of these men both before and after treatment. In six men, the organism was isolated after but not before treatment. No isolates were obtained from the remaining men either before or after treatment. All 17 of the men who yielded C. trachomatis developed post-gonococcal urethritis. Eight of 46 men from whom no isolate was obtained in their cultures developed post-gonococcal urethritis. Seventeen of 50 women successfully treated with spectinomycin for cervical infections with N. gonorrhoeae yielded isolates of C. trachomatis both before and after treatment. The organism was isolated from five women before but not after treatment, and from four women after but not before treatment. In 24 women culture for C. trachomatis was negative both before and after treatment. Spectinomycin hydrochloride in the dosage used rarely eliminated C. trachomatis from the genital tract of either men or women; in this respect it resembled two other drugs commonly used for the treatment of gonorrhoea-pencillin and ampicillin.     

An observational cohort study of Chlamydia trachomatis treatment in pregnancy

BACKGROUND AND OBJECTIVES: Currently, azithromycin is not considered a first-line treatment for Chlamydia trachomatis in pregnant women. We evaluated the use, efficacy, and safety of azithromycin compared with erythromycin and amoxicillin in the treatment of genital chlamydial infection during pregnancy. METHODS: This was a retrospective cohort study of pregnant women with genital chlamydial infection. Data on antibiotics prescribed, test-of-cure (TOC) results, and maternal and infant complications were collected from medical records. RESULTS: Of the 277 women in the study sample, 69% were initially prescribed azithromycin, 9% amoxicillin, and 19% erythromycin. Eight-one percent of subjects had a TOC 7 or more days after diagnosis and before delivery. Treatment efficacy, as defined by a negative TOC, was 97% (95% confidence interval [CI], 92.9-99.2) for azithromycin, 95% (95% CI, 76.2-99.9) for amoxicillin, and 64% (95% CI, 44.1-81.4) for erythromycin. The efficacy of azithromycin was significantly higher than erythromycin (P < 0.0001). There were no significant differences in efficacy by age, race/ethnicity, concurrent sexually transmitted disease diagnosis, partner treatment, or substance use. Furthermore, there was no difference in complications for women or infants exposed to azithromycin compared with those treated with other regimens. CONCLUSION: Clinical outcome data from this study population of women and infants support both efficacy and safety of azithromycin for treatment of C. trachomatis in pregnancy.     

The role of Chlamydia trachomatis in prostatitis syndrome--our experience in diagnosis and treatment

Since the beginning of 1999, over 1500 patients with symptoms of chronic prostatitis were examined at Dr. Fran Mihaljevi? University Hospital for Infectious Diseases in Zagreb. In almost all of these patients urethral swabs and quantitative segmented bacteriologic cultures and microscopy of expressed prostatic secretion (EPS) or voided bladder urine3 (VB3) were performed as described by Meares and Stamey. Urethral swabs, EPS or VB3 were examined for the presence of Chlamydia (C.) trachomatis by McCoy culture and Lugol stain or by immunofluorescent typing with monoclonal antibodies. In the majority of patients C. trachomatis was demonstrated in parallel in EPS or VB3 by DNA/RNA hybridization method. Normal white blood cell count viewed per high power field<10 was found in 362 (68%) of 536 patients with symptoms of chronic prostatitis and C. trachomatis detected in EPS or VB3. These findings additionally suggest that C. trachomatis can be suspected as a causative pathogen in all categories of chronic prostatitis syndrome. Furthermore, this paper summarizes the results of five previously published clinical studies on the efficacy and tolerability of various treatment schemes for chronic chlamydial prostatitis, conducted from the beginning of 1999 until the end of 2003.     

Improved management in the diagnosis of gonorrhoea in women

In this paper an evaluation is made of the endeavours to improve diagnosis in women named as contacts of gonorrhoea. The problem was approached in three ways. (a) The number of sites sampled was increased. (b) The results of microscopical examination of smears made by clinical staff were regularly evaluated. (c) Cultural examinations by the supporting laboratory were dealt with more efficiently and speedily. It is concluded that the number of tests currently used to establish or exclude a diagnosis of gonorrhoea in women can safely be reduced to two, and that the methods currently in use allow a more cost-effective management of an increasing case load.     

Amoxycillin in the treatment of gonorrhoea.

A series of 162 patients with uncomplicated genital gonorrhoea was assessed after single-dose treatment with 3 g. amoxycillin. This seems to be an acceptable method of treatment, resulting in clearance rates in both male and female patients of 99 and 95% respectively at the first follow-up. The default rates on follow-up over a 4-week period are also shown.