[Spectinomycin therapy in combination with ampicillin in female patients with acute gonorrhea]

Clinical effects of spectinomycin (Trobicin, 2 g. i.m., once a day) and ampicillin (1 g/day, p.o., in 4 divided doses, for 2 days) given in combination on acute gonorrhea in female patients were studied, and sensitivity of isolated gonococci to each of these antibiotics was determined. 1. Clinical effects were evaluated by cultures of gonococci from discharge collected at 72 hours after spectinomycin administration and 12 hours after the last dose of ampicillin and both subjective and objective clinical findings. Among 20 cases of gonorrhea treated, 12 cases (60.0%) proved excellent in therapeutic results, 6 cases (30.0%) good, 1 case fair and 1 case produced no response. The success rate comprising excellent and good was 90.0%. The only side effect reported was pain of injection site in 1 case on 3 days after initiation of treatment, but no induration was noted. 2. MICs of spectinomycin and ampicillin for gonococci collected from the 20 cases were determined. Spectinomycin showed MICs of 6.25 approximately 12.5 micrograms/ml against 10(8) CFU/ml and 3.13 approximately 12.5 micrograms/ml against 10(8) CFU/ml. These values were below the blood concentration obtained at 6 hours after intramuscular administration of 2 g of spectinomycin. Ampicillin had MICs of 0.1 approximately 25 micrograms/ml against 10(8) CFU/ml and 0.1 approximately 3.13 micrograms/ml against 10(6) CFU/ml. Five strains, MICs of which were 6.25 approximately 25 micrograms/ml against 10(8) CFU/ml, were beta-lactamase-producing.