Comparison of single-dose ceftizoxime or ceftriaxone in the treatment of uncomplicated urethral gonorrhea.

Penicillinase-producing strains of Neisseria gonorrhoeae account for an increasing percentage of cases of gonorrhea in the United States. Although many strains of N. gonorrhoeae are still sensitive to penicillin, the CDC currently recommends one dose of ceftriaxone 250 mg IM for treatment of uncomplicated urethral gonorrhea. Ceftizoxime like ceftriaxone is a third generation cephalosporin that demonstrates excellent MICs against beta-lactamase positive and negative strains of N. gonorrhoeae. The clinical efficacy of a single-dose of ceftizoxime 250 mg IM was compared with ceftriaxone 250 mg IM in patients with uncomplicated urethral gonorrhea. In addition, the cost of each regimen was evaluated to determine the most cost-effective agent. A total of 106 and 98 patients were treated with ceftizoxime and ceftriaxone, respectively, with all cases cured. PPNG strains were observed in 25.5% of patients. No adverse events were observed or reported. The cost of ceftizoxime was approximately one-third that of ceftriaxone ($2.37 to $2.56 and $7.15 to $8.70 per dose, respectively). The data from this study suggest that ceftizoxime 250 mg IM is a safe, cost-effective alternative to the use of ceftriaxone 250 mg IM in the treatment of patients with PPNG-positive and -negative gonorrhea.