Epidemiology and treatment of oropharyngeal gonorrhea

The natural history, transmissibility, and treatment of oropharyngeal gonorrhea have been incompletely examined in previous studies. We repeated cultures on 60 patients with untreated pharyngeal gonorrhea, before treatment. The probability that the culture would remain positive decreased progressively as the interval between cultures increased, suggesting self-limited colonization. Gonococci were easily grown from expectorated saliva in 34 of 51 cultures from patients with oropharyngeal gonorrhea, suggesting transmissibility and providing another reason for ensuring effective treatment. Five treatment regimens were evaluated in 292 cases of oropharyngeal gonorrhea. Compared with aqueous procaine penicillin G, single-dose ampicillin and spectinomycin had unacceptably higher failure rates, and oral tetracycline given for 5 or 7 days was shown to be effective. A simple oral regimen providing a second dose of ampicillin plus probenecid 8 to 14 hours after the first dose was also effective.