Cefoxitin in the treatment of gonorrhea

Cefoxitin is active in vitro against beta-lactamase-producing strains of Neisseria gonorrhoeae; therefore, its efficacy in the treatment of uncomplicated genital gonorrhea was evaluated in a study of ten men and 15 women. Cefoxitin was administered in two intramuscular doses given 5 hr apart, patients alternately receiving either 1 g or 2 g of cefoxitin in each injection. Probenecid (1 g) was administered orally with both injections to five women, and with the first injection only in the remaining patients. All cases of gonococcal cervicitis or urethritis were cured, and all rectal carriage was eliminated. Four of seven patients had persistent oropharyngeal carriage after treatment. There was no discernible difference between the efficacies of the 1-g and 2-g regimens. It was concluded that the cefoxitin regimens used are effective for therapy of uncomplicated genital or anorectal gonorrhea, but not for eradication of oropharyngeal carriage of N. gonorrhoeae.