The frequent presence of chlamydia among patients at STD clinics who received treatment for gonorrhea, including sex partners of gonorrhea-infected patients, supports continuing current recommendations for co-treatment.

Although invasive pneumococcal infections are common among men infected with human immunodeficiency virus (HIV), the prevalence of pharyngeal colonization with Streptococcus pneumoniae was not significantly different among HIV-infected patients (8 [14%] of 56) and HIV-seronegative men (9 [9%] of 99) attending a sexually transmitted disease clinic. Sixteen HIV-infected men (mean CD4+ T cell count, 132 +/- 37/microL) developed pneumococcal bacteremia, accounting for 13.6% of 117 total cases and 42% of 38 cases in men 16-55 years old. Serum killing activity, a measure of functional humoral response to S. pneumoniae, was lower in 4 (67%) of 6 acute sera and 6 (54%) of 11 convalescent sera from bacteremic HIV-infected patients when compared with baseline sera of 7 HIV-seronegative healthy subjects. These findings suggest that the high rates of pneumococcal bacteremia among HIV-infected patients may be associated with low numbers of CD4+ T cells and impaired humoral responses to S. pneumoniae rather than to increased exposure to the organism.

In the treatment of uncomplicated gonorrhea, a single dose of cefixime (400 or 800 mg) given orally appears to be as effective as the currently recommended regimen of ceftriaxone (250 mg given intramuscularly).

The in vitro activity of Ro 13-9904, a new cephalosporin derivative, was compared with the activities of cephalothin, cefamandole, cefoxitin, cefotaxime, and moxalactam against 591 clinical isolates of gram-negative and gram-positive organisms. The spectra of activity and potency of Ro and cefotaxime were quite similar; they were the most active agents against Enterobacteriaceae, Streptococcus pyogenes, Haemophilus influenzae, Neisseria gonorrhoeae, and Neisseria meningitidis. Moxalactam was only slightly less active against these organisms. Ro 13-9904, cefotaxime, and moxalactam were approximately equal in activity against Pseudomonas aeruginosa; concentrations of 50 to 100 ,Ig/ml inhibited over 90% of the strains tested. Cefamandole and cephalothin were the most active drugs tested against staphylococci. Moxalactam demonstrated the highest intrinsic activity against Bacteroides fragilis; a concentration of 1.6 yg/ ml inhibited over 50% of the strains. All six of the antibiotics were essentially inactive against group D streptococci. The action of all of the antibiotics was bactericidal, with minimal bactericidal concentrations generally being no more than twofold greater than miniimal inhibitory concentrations. The only exception to this was found when large inocula of Staphylococcus aureus were tested. Increased inoculum size generally sharply reduced the activity of Ro 13-9904, cefotaxime, and moxalactam against Enterobacteriaceae and P. aeruginosa.The chemotherapy of serious bacterial infections, particularly those which are hospital acquired, is a continuing clinical challenge. Organisms such as Serratia, Acinetobacter, Pseudomonas cepacia, and others once thought to cause disease only rarely, if at all, are now recognized as common pathogens. The need for antimicrobial agents with broad spectra of activity and resistance to the /3-lactamases of gramnegative organisms associated with nosocomial infection has motivated research resulting in the development of a great number of cephalosporin derivatives. Since the discovery of the fungus Cephalosporium acremonium in Sardinian sewage in 1945 (1), the cephalosporins have evolved into a complex group of antibiotics with significant differences in potency and antibacterial spectrum. Ro 13-9904 (Fig. 1) is a new product of the chemical manipulation of side chains joined to the 7-amino-cephalosporanic acid nucleus. It has been reported to be highly active against common gram-negative organisms and relatively resistant to inactivation by cephalosporinases; preliminary data also suggest that the expanded spectrum of activity includes Pseudomonas aeruginosa, Serratia marcesens, and most strains of Enterobacter (compound Ro 13-9904 preliminary data, Hoffmann-La Roche, Inc., 1979).The purpose of this study was to compare the in vitro activity of Ro 13-9904 with the activities of other drugs representing the three major generations of cephalosporin development. The first generation was represented by cephalothin, the second was represented by cefamandole and cefoxit...

Urine chlamydial screening by polymerase chain reaction of sexually active male youth in nontraditional settings appears to be feasible and to provide yields similar to those reported in standard clinic settings. Evaluation of samples easily collected in nonclinic locations holds great promise as an additional strategy for the control of chlamydial infection and other STD among difficult-to-reach populations.