Comparative study of treatment of uncomplicated gonorrhea with thiamphenicol and cefotaxime

Results of treatment of uncomplicated urogenital gonorrhea caused by penicillinase- and non-penicillinase-producing Neisseria gonorrhoeae were compared. In The Hague treatment consisted of thiamphenicol (2.5 g given orally), whereas the treatment in Rotterdam was cefotaxime (1 g given im). All isolates were tested for production of penicillinase and sensitivity to cefotaxime and thiamphenicol. Special attention was given to possible hematological effects of treatments with thiamphenicol. Of 55 patients treated with thiamphenicol, 87.3% were cured; however, all of 55 patients treated with cefotaxime were cured. The frequency of postgonococcal urethritis among male patients was 34.1% after thiamphenicol and 39.5% after cefotaxime treatment. The only adverse effect seen after cefotaxime treatment was a rash (2%). After treatment with thiamphenicol, 10.9% of patients had diarrhea. No significant changes in hematologic tests were seen after treatment with thiamphenicol. There was a remarkable and significant difference in sensitivity to thiamphenicol between the two treatment groups; this fact could point to the importance of specific local factors in comparison of different treatments for gonorrhea.