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Single dose piperacillin in treating uncomplicated gonococcal urethritis in men
T Thirumoorthy1, K B Lim, C T Lee
1Middle Road Hospital, Singapore.
Genitourinary Medicine
|October 1, 1987
Summary
A piperacillin and probenecid treatment effectively cured uncomplicated gonorrhea from non-penicillinase-producing Neisseria gonorrhoeae strains. However, it showed lower efficacy against penicillinase-producing strains, indicating it is not ideal for high-prevalence areas.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Neisseria gonorrhoeae is a significant cause of sexually transmitted infections.
- Penicillinase-producing Neisseria gonorrhoeae (PPNG) strains present a treatment challenge.
- Uncomplicated gonococcal urethritis requires effective and accessible treatment options.
Purpose of the Study:
- To evaluate the efficacy of a single intramuscular dose of piperacillin combined with oral probenecid for treating uncomplicated gonococcal urethritis.
- To compare treatment outcomes between infections caused by PPNG and non-PPNG strains.
Main Methods:
- A total of 82 men with uncomplicated gonococcal urethritis were treated.
- Treatment consisted of a single intramuscular dose of piperacillin (2 g) and oral probenecid (1 g).
- Antibiotic susceptibility testing, including Minimum Inhibitory Concentrations (MICs), was performed on Neisseria gonorrhoeae isolates.
Main Results:
- An overall treatment success rate of 90% was achieved.
- All 49 patients infected with non-PPNG strains were cured (100% success).
- A 76% cure rate was observed in 33 patients infected with PPNG strains.
- Post-gonococcal urethritis (PGU) occurred in 18% of patients.
- MICs for piperacillin were low (≤2 mg/l) for most non-PPNG strains but high (≥32 mg/l) for a majority of PPNG strains.
Conclusions:
- The piperacillin-probenecid regimen is highly effective against non-PPNG strains of Neisseria gonorrhoeae.
- This treatment is not recommended as a first-line therapy in regions with a high prevalence of PPNG infections.
- Further research may be needed to optimize treatment strategies for PPNG infections.