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Published on: December 27, 2016

Comparative Efficacy of Penicillin and Doxycycline in Gonococcal Urethritis

Vinod K Sharma, R K Pandhi, R A Bhujwala

    Indian Journal of Dermatology, Venereology and Leprology
    |February 2, 2017
    PubMed

    Insights

    Penicillin with probenecid showed the highest cure rate for gonococcal urethritis. Doxycycline was less effective, and post-gonococcal urethritis occurred in over a third of patients.

    Area of Science:

    • * Infectious Diseases
    • * Urology
    • * Microbiology

    Background:

    • * Gonococcal urethritis remains a significant public health concern.
    • * Emerging antibiotic resistance in Neisseria gonorrhoeae necessitates evaluating treatment efficacy.
    • * Penicillin and doxycycline are common treatment options for gonococcal infections.

    Purpose of the Study:

    • * To compare the efficacy of three different treatment regimens for gonococcal urethritis.
    • * To assess the incidence of post-gonococcal urethritis.
    • * To determine the susceptibility of Neisseria gonorrhoeae isolates to penicillin.

    Main Methods:

    • * A comparative study involving 92 episodes of gonococcal urethritis.
    • * Treatment regimens included: fortified procaine penicillin with probenecid, fortified procaine penicillin alone, and oral doxycycline.
    • * Antimicrobial susceptibility testing was performed on Neisseria gonorrhoeae isolates.

    Main Results:

    • * Success rates were 95% for penicillin with probenecid, 76.2% for penicillin alone, and 66.7% for doxycycline.
    • * Post-gonococcal urethritis was observed in 37% of patients.
    • * 45.94% of isolates showed relative penicillin resistance (MIC ≥ 0.12 units/mL); no beta-lactamase production was detected.

    Conclusions:

    • * Fortified procaine penicillin combined with probenecid is the most effective treatment for gonococcal urethritis in this study.
    • * The high rate of post-gonococcal urethritis warrants further investigation.
    • * Penicillin resistance is present, but beta-lactamase production is not a factor in these isolates.

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