Single-dose treatment of uncomplicated gonococcal urethritis: a comparison of cefonicid and penicillin

Cefonicid, a parenterally administered semisynthetic cephalosporin, produces high and sustained serum levels in humans. It is active in vitro against Neisseria gonorrhoeae, including beta-lactamase-producing strains. Therefore, the efficacy of cefonicid in treatment of men with uncomplicated gonococcal urethritis was evaluated in a two-phase study. Initially, 58 men were treated intramuscularly with 1 g of cefonicid. There were four failures among the 50 patients who could be evaluated. In the second phase (a double-blind study), 57 men received either 1.0 g of cefonicid or 4.8 x 10(6) units of procaine penicillin G plus 1.0 g of probenecid. Among 17 men treated with penicillin, there were two failures; among the 33 cefonicid-treated patients, there was only one failure. Thus, 78 (94%) of 83 patients receiving cefonicid were cured. Of the 85 pretreatment and four posttreatment isolates tested, 31 were inhibited by less than 0.0625 microgram of penicillin/ml and 87 were inhibited by less than 1.0 microgram/ml. Twenty-eight of the 89 isolates were inhibited by less than 0.0625 microgram of cefonicid/ml and 88, by less than 1.0 microgram of cefonicid/ml. It is concluded that 1.0 g of cefonicid given intramuscularly is effective therapy for uncomplicated gonococcal urethritis.