The effect of pivampicillin and probenecid on experimental syphilis in rabbits]

The oral single-dose-treatment of the acute gonorrhoeal urethritis of the male with 1.4 g pivampicillin and 1.0 g probenecid is one of the possible alternatives to a parenteral penicillin treatment. Experiments were performed on rabbits to determine if this dose of pivampicillin and probenecid could cure a simultaneously acquired syphilis at a very early stage of incubation. 300 treponems (Nichols strain, T. pallidum) were inoculated intratesticularly and 3 days later pivampicillin and probenecid were administered in doses which produced antibiotic serum levels similar to those in patients who had received a single oral dose of 1.4 g pivampicillin and 1.0 g probenecid. Controls over a 15-weeks period showed that this dosage did prevent the development of syphilitic orchitis and reactivity to the quantitative FTA-ABS-test. It is concluded that the treatment of acute gonorrhoea with 1.4 g pivampicillin and 1.0 g probenecid in general is sufficient to cure a simultaneously acquired syphilis.     

Evaluation of treatment with single-dose ampicillin/sulbactam with probenecid or ceftriaxone in patients with uncomplicated gonorrhea.

This study compared ampicillin/sulbactam plus probenecid with ceftriaxone for treatment of uncomplicated gonorrhea. Of the 297 men and women who were enrolled and randomized to receive either ampicillin/sulbactam (1.0 g/0.5 g) with probenecid (1 g) or ceftriaxone (0.25 g), 274 patients were evaluable. Both ampicillin/sulbactam and ceftriaxone were administered by intramuscular injections. Patients were gonococcal contacts, had positive culture results for Neisseria gonorrhoeae, or had clinical evidence of gonorrhea. Specimens for gonococcal cultures were collected from the cervix (female patients), urethra, rectum, and pharynx at pretreatment and test-of-cure visits. The presence of N. gonorrhoeae and a test-of-cure visit were required for drug efficacy analysis. Of the 274 evaluable patients, 195 (71.2%) had positive culture results for N. gonorrhoeae. Cure was achieved in 93 (94.9%) of 98 patients receiving ampicillin/sulbactam with probenecid and in 96 (99.0%) of 97 patients receiving ceftriaxone. Penicillinase-producing N. gonorrhoeae strains were found in 21 (10.8%) patients; these were eradicated by either ampicillin/sulbactam with probenecid (N = 9) or ceftriaxone (N = 12). Overall, the two drug regimens were very well tolerated and no serious adverse effects were noted. Ampicillin/sulbactam with probenecid may be useful as single-dose therapy in patients with uncomplicated genitorectal gonorrhea.     

Talampicillin and probenecid compared with ampicillin and probenecid for the treatment of gonococcal urethritis in men.

Two hundred and ten men suffering from uncomplicated gonococcal urethritis were treated with one of two treatment schedules. Of 109 patients treated with 3 g ampicillin and 2 g probenecid (group A) there were two recurrences in the first week after treatment and none in the second week. Of 101 patients treated with 1.5 g talampicillin and 2 g probenecid (group B), there were three recurrences in the first week and none in the second week. Both antibiotics were well tolerated, but one patient vomited two hours after taking talampicillin. The sensitivity pattern of Neisseria gonorrhoeae to penicillin at The London Hospital has shown an increase in the proportion of more sensitive strains during the last three years. Talampicillin given in a single dose with probenecid is satisfactory in the treatment of acute gonococcal urethritis but, apart from the smaller dosage, it does not offer any advantage over ampicillin with probenecid.     

Cefixime in the treatment of uncomplicated gonorrhea.

One hundred consecutive patients with uncomplicated gonorrhea were treated with 800 mg of cefixime. Follow-up evaluation was obtained for 73 patients, and at that time 71 of the 73 had negative culture results for Neisseria gonorrhoeae. Minimal adverse side effects were reported. Cefixime 800 mg appears to be an excellent treatment for uncomplicated gonorrhea.     

Comparison of fleroxacin and penicillin G plus probenecid in the treatment of acute uncomplicated gonococcal infections.

OBJECTIVE--To investigate the activity of fleroxacin in acute uncomplicated infections with N. gonorrhoeae in comparison with conventional penicillin G plus probenecid treatment. DESIGN--Multicentre open label randomised parallel group study. SUBJECTS--Male patients aged 18 years or over from university departments of urology, epidemiology and dermatology and a clinic for sexually transmitted diseases. INTERVENTIONS--Two hundred and sixty male patients were randomly assigned to treatment with either a single oral dose of fleroxacin 400 mg (130 patients) or a single intramuscular dose of penicillin G (2.4 or 5.0 mega units) plus a single oral dose of probenecid 1 gram (130 patients). Efficacy and safety assessments were undertaken at follow-up (3-14 days after treatment). Efficacy was assessed as bacteriological outcome of treatment. Safety was assessed by evaluation of adverse events, laboratory abnormalities and changes in vital signs. RESULTS--Two hundred and twenty four patients (114 in the fleroxacin group and 110 in the penicillin plus probenecid group) were evaluated for efficacy. Bacteriological cures were achieved in 100% of patients in the fleroxacin group and 97% of patients in the penicillin plus probenecid group. There was no statistically significant difference between the two groups in this respect (Fisher exact test, p = 0.25). Clinical cures were achieved in 100% of patients receiving fleroxacin and 95% of patients receiving penicillin plus probenecid. Safety analyses were undertaken on 255 patients (126 in the fleroxacin group and 129 in the penicillin plus probenecid group). No adverse events were reported for either treatment group, and no clinically relevant laboratory abnormalities were apparent. Thus, there appeared to be no difference in the efficacy or safety of these two treatments when used to treat acute, uncomplicated urethral gonorrhoea in males. CONCLUSIONS--In this study fleroxacin proved to be highly effective therapy for uncomplicated gonococcal urethritis in males and may provide a favourable alternative to standard treatment.     

Ampicillin plus probenecid compared with procaine penicillin plus probenecid in the treatment of gonorrhoea.

396 male patients with gonococcal urethritis were treated by one of three treatment schedules. Of 132 patients treated with 2.4 m.u. procaine penicillin plus 2 g. probenecid, 109 were followed. There were three (2.8 per cent) recurrences in the first week and none in the second. Of 132 patients treated with 2 g. ampicillin plus 2 g. probenecid, 112 were followed. There were four (3.6 per cent.) recurrences in the first week and three (2.6 per cent.) in the second (total of 6.2 per cent.). Of 132 patients treated with 3 g. ampicillin plus 2 g. probenecid, 115 were followed. There was one (0.8 per cent.) recurrence in the first week and five (4.4 per cent.) in the second (total of 5.2 per cent.). A close correlation was found between the sensitivities of gonococcal strains to ampicillin and to penicillin. The overall sensitivity pattern of N. gonorrhoeae to penicillin had not changed at The London Hospital since the last report in 1972, but there was further evidence of cross-resistance between penicillin and cotrimoxazole.     

Ampicillin plus probenecid compared with procaine penicillin plus probenecid in the treatment of gonorrhoea.

396 male patients with gonococcal urethritis were treated by one of three treatment schedules. Of 132 patients treated with 2.4 m.u. procaine penicillin plus 2 g. probenecid, 109 were followed. There were three (2.8 per cent) recurrences in the first week and none in the second. Of 132 patients treated with 2 g. ampicillin plus 2 g. probenecid, 112 were followed. There were four (3.6 per cent.) recurrences in the first week and three (2.6 per cent.) in the second (total of 6.2 per cent.). Of 132 patients treated with 3 g. ampicillin plus 2 g. probenecid, 115 were followed. There was one (0.8 per cent.) recurrence in the first week and five (4.4 per cent.) in the second (total of 5.2 per cent.). A close correlation was found between the sensitivities of gonococcal strains to ampicillin and to penicillin. The overall sensitivity pattern of N. gonorrhoeae to penicillin had not changed at The London Hospital since the last report in 1972, but there was further evidence of cross-resistance between penicillin and cotrimoxazole.     

头孢曲松钠与法罗培南钠片治疗男性淋病的临床效果比较

目的:研究男性淋病患者应用头孢曲松钠与法罗培南钠片进行联合治疗的临床效果。方法:回顾分析我院自2009年10月至2013年10月于我科治疗的93例男性淋病患者临床资料,依据治疗方式将其分为研究组(n=47)与对照组(n=46),对照组单纯应用头孢曲松钠肌注治疗,研究组基于对照组治疗方案,联合应用法罗培南钠片口服治疗,两组疗程均为10d,对两组总有效率、不良反应、排尿评分、疼痛评分等进行对比分析。结果:研究组总有效率为95.7%,对照组总有效率为84.8%,两组呈明显差异(P0.05)。两组均有不良反应发生,给予对症处理后均可缓解,不具统计学差异(P0.05)。研究组治疗前排尿评分与对照组相较,不具差异(P0.05),研究组治疗后排尿评分与对照组相较,呈明显差异(P0.05)。研究组治疗前疼痛评分与对照组相较,不具差异(P0.05),研究组治疗后疼痛评分与对照组相较,呈明显差异(P0.05)。结论:男性淋病患者应用头孢曲松钠与法罗培南钠片进行联合治疗,不仅安全系数较高,而且不良反应较少,能够减轻患者痛苦,提高生活质量,效果显著,应予推广。