Cefuroxime, thiamphenicol, spectinomycin, and penicillin G in uncomplicated infections due to penicillinase-producing strains of Neisseria gonorrhoeae.

The use of cefuroxime and thiamphenicol in uncomplicated gonococcal infection was studied in 562 women confined to a clinic to preclude reinfection before cultural confirmation of cure. Cefuroxime was as effective as spectinomycin in the treatment of infections due to penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) and was significantly more effective than 4.8 units of aqueous procaine penicillin G with probenecid among non-penicillinase-producing (non-PPNG) strains. Thiamphenicol was highly effective against PPNG, but the failure rate in infections with non-PPNG was high and appeared to be related to the minimum inhibitory concentrations of thiamphenicol. This rate was not, however, significantly higher than that for PPNG strains. Thiamphenicol might therefore be used as an alternative for infections due to PPNG strains. If, however, thiamphenicol is used widely, selection of more resistant strains and thus an increasing proportion of failures may be expected.