Evaluation of the in vitro activity of six antimicrobial agents against Neisseria gonorrhoeae

Abstract

SUMMARYUse of antimicrobials for the treatment of gonorrhea started in 1930 with the utilization of sulfonamides. With the years other drugs were used for its treatment such as penicillin, tetracycline, spectinomycin, and others. Although highly specific in the beginning, these drugs, with time did not show anymore the expected therapeutic results because of aspects of chromosomal and plasmid-mediated resistance. The purpose of this study was to evaluate the susceptibility of Neisseria gonorrhoeae strains to six drugs used for its treatment (penicillin, tetracycline, cefoxitin, thiamphenicol, spectinomycin and ofloxacin) by the determination of minimal inhibitory concentrations of these drugs. We concluded that drugs, such as cefoxitin, thiamphenicol and spectinomycin still are excellent pharmacological agents for the treatment of gonorrhea. Penicillin, although still efficient, needs more attention regarding its use, as well as ofloxacin, because of the emergence of resistant strains. Tetracycline and its derivatives should be strongly contraindicated for the treatment of gonorrhea.

A Rare Case of Disseminated Pyogenic Gonococcal Infection in an Immunocompetent Woman

“…Of note, cefoxitin used to treat probable cholecystitis did not prove efficient against gonococcal syndrome although it is considered in vitro active. This underlies the fact that the efficacy of an antibiotic is not determined only by antibiotic pharmacodynamics but is based on pharmacokinetics/pharmacodynamics index, which was possibly not fulfilled in this case [4]. On the other hand, although azithromycin was resistant in vitro, it was included in the therapeutic regimen at least for a potential broader and enhanced activity given the rapid evolution of the clinical condition.…”