Diagnostic treatment and reporting criteria for gonorrhoea in sexually transmitted disease clinics in England and Wales. 2: treatment and reporting criteria.

Abstract

SUMMARY The current methods of treatment and reporting are described. The most common form of treatment for gonorrhoea in men and women was a single dose of oral ampicillin, usually 2 g. In proportionately more of the clinics treating women, treatment was given over several days. The wide use of ampicillin represents a marked change in treatment practice during the last decade. Procaine penicillin was the most commonly used parenteral preparation. The two dosages used most often for men were 1-2 and 2-4 megaunits. In women the commonest regimen was 2-4 megaunits and again there was a tendency for treatment to be given over several days. Epidemiological treatment was used widely and in one-third of clinics this occurred without confirmation that the patient was a true contact. Consultants used varying diagnoses on the quarterly returns for patients treated epidemiologically in whom the smears and/or cultures were negative. Most clinics classified these cases as 'other conditions requiring treatment' (D2) but as many as 19 % of clinics designated these cases as being 'true' gonorrhoea. It is suggested that this results in an overestimate of the number of cases of 'real' gonorrhoea treated in England and Wales.

Diagnostic, treatment, and reporting criteria for non-specific genital infection in sexually transmitted disease clinics in England and Wales. 2: Treatment and reporting criteria.

“…This may appear tidy but will only make this category even more of a dumping ground than it is already. For instance, most consultants who treat sexual contacts with gonorrhoea on epidemiological grounds use this category (Adler, 1978b). The other option is for all such cases to be returned as 'non-specific genital infection' with a clear indication that they have been treated epidemiologically in the absence of positive findings.…”

Comparison of minocycline and ampicillin in gonococcal urethritis.

“…Gundersen et al (1969), as have others since, showed that the addition of probenecid, which blocks the renal excretion of penicillin causing a higher serum concentration, alleviated this problem. Adler (1978a) found that ampicillin was the most commonly prescribed antimicrobial for men with gonorrhoea in England and Wales, being used together with probenecid in onethird of clinics. It has no effect, however, when used as pivampicillin (Pondocillin) (an ampicillin derivative) on the development of PGU (Waugh and Nayyar, 1977).…”