Treatment of gonococcal urethritis in men with a rifampicin-erythromycin combination

A group of men with uncomplicated gonococcal urethritis were treated with a single oral dose of rifampicin (900 mg) and erythromycin stearate (1 g). Neisseria gonorrhoeae was isolated from four of 108 men at the first follow-up examination, and from none of 68 who attended a second follow-up examination. It is concluded that this rifampicin-erythromycin combination may be useful for the therapy of gonorrhea. It may be of particular value in the treatment of infections due to penicillin-resistant N. gonorrhoeae, since in vitro studies showed that both rifampicin and erythromycin were active against 20 strains of beta-lactamase-producing N. gonorrhoeae. The effect of this rifampicin-erythromycin combination against associated infections with Chlamydia trachomatis was disappointing. This organism was isolated from five of nine patients who had yielded isolates of C. trachomatis before treatment.