One-hundred thirteen men (mean age, 23 years) who presented with inguinal buboes to a government-operated hospital for sexually transmitted diseases (STDs) in Bangkok were studied between February 1987 and February 1989. The median duration of preceding symptoms was 7 days (range, 1-62 days). The majority of patients (74; 65%) had received treatment previously; 31 (27%) were febrile, 13 (12%) had extrainguinal lymphadenopathy, and 31 (27%) had concurrent active genital ulcers. There was no history of genital ulceration in 66 (58%) of the patients. Pus was obtained from 51 of the 110 buboes aspirated for culture; 21 (41%) of these cultures yielded Haemophilus ducreyi, and 2 (3.9%) were positive for Chlamydia trachomatis on immunofluorescence microscopy. Saline (1 mL) was injected and reaspirated from the buboes of 35 of the other 59 patients; 3 buboes yielded H. ducreyi and 9 were positive for C. trachomatis. All cultures for other aerobic and anaerobic bacteria and viruses in intact buboes were negative. Syphilis serology was positive in only one case. Patients attending STD clinics in this region who have large, fluctuant, edematous inguinal buboes containing pus should receive presumptive treatment for chancroid. If there is no pus, then the bubo is more likely to be caused by lymphogranuloma venereum.

A randomised double blind trial comparing single oral dose therapy with 200 mg and 400 mg of ofloxacin, respectively was conducted at the Bangrak Hospital, Bangkok during the period December 6, 1985 to January 24, 1986. We treated 234 male patients diagnosed as having uncomplicated gonococcal urethritis with ofloxacin. Ofloxacin, at a single dose of 200 mg or 400 mg, was given to each of them. Fourteen patients were excluded for efficacy assessment. There were 223 patients left for safety assessment. The cure rates were 100% in both groups. Among 233 isolates tested, 48.5% were penicillinase producing Neisseria gonorrhoeae. The range of minimum inhibitory concentrations of ofloxacin was 0.008 to 0.063 mg/l. No adverse drug experiences were reported.

Cefaclor at a dose of 3 g given orally with 1 g probenecid appears to be an effective alternative to spectinomycin 2 g in the treatment of gonorrhoea in areas where strains of penicillinase producing Neisseria gonorrhoeae (PPNG) are prevalent.

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