Norfloxacin in the therapy of gonococcal infections

Norfloxacin is a quinolone derivative with demonstrated activity against Neisseria gonorrhoeae. The MIC90 against penicillinase- and non-penicillinase producing N. gonorrhoeae is 0.06 mg/l and 0.015 mg/l respectively. The drug is rapidly absorbed with a single oral dose of 800 mg producing peak serum levels of 2.45 mg/l. In this open, uncontrolled study, 70 patients with laboratory confirmed, uncomplicated infections with N. gonorrhoeae were entered to determine the efficacy and safety of a single oral dose of norfloxacin 800 mg. Thirty-one males and 27 females were evaluated for efficacy with 34 males and 25 females evaluated for safety. Norfloxacin cured all 31 urethral and two pharyngeal infections in men. All 25 females with endocervical infections and six with rectal involvement were also cured. The single treatment failure occurred in a woman who had persistent pharyngeal infection. All isolates of N. gonorrhoeae were inhibited by 0.05 mg/l of norfloxacin. The incidence of adverse effects was 23.7% but all were mild, required no specific therapy and cleared without sequelae. In this study, norfloxacin proved to be an effective agent in the therapy of uncomplicated gonococcal infection in males and females. It has previously been proven to be useful in the therapy of gonococcal infections due to penicillinase-producing N. gonorrhoeae and the value of this drug as a first line choice in the treatment of gonococcal infections is discussed.