Gonorrheal Urethritis in Males Treated with a Single Oral Dose of Minocycline

Thatcher, Richard W.; Pazin, George J.; Domescik, Gerald

doi:10.2307/4593816

Cited by 15 publications

(4 citation statements)

References 2 publications

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“…Our failure rates were much higher than those reported by Thatcher, Pazin and Domescik (1970) using minocycline in the treatment of gonococcal urethritis in men. Their failure rates in patients returning within 96 hours ranged from 8 per cent.…”

Section: Discussioncontrasting

confidence: 75%

Treatment of gonorrhoea with a single oral dose of minocycline.

Duncan¹,

Glicksman²,

Knox³

et al. 1971

Sexually Transmitted Infections

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The gradual decrease in susceptibility of the gonococcus to penicillin has led authorities to recommend ever larger doses for the therapy of gonorrhoea. The current recommendation of the U.S. Public Health Service for the treatment of infections in women is the administration of 4-8 m.u. aqueous procaine penicillin; one half that amount is advised for cases in men.In seeking alternative antibiotics for the treatment of gonorrhoea, we have recently completed a trial of minocycline (7 dimethylamino-6-deoxy-6-dimethyltetracycine), a new semisynthetic derivative of tetracycline. The preparation and some biological properties of minocycline were described by Martell and Boothe (1967).Subsequent investigations (Fedorko, Katz, and Allnoch, 1968;Frisk and Tunevall, 1969; Washington, Yu, and Martin, 1970) have shown minocycline to have a broad spectrum much like tetracycline, with apparently more activity against the staphylococcus than tetracycline. Martin, Lester, Kellogg, and Thayer (1969) found that gonococcal strains isolated from patients after failure of treatment with penicillin were inhibited in vitro by minocycline at lower concentrations than was the case with tetracycline or doxycycline. The minimum inhibitory concentration (MIC) of minocycline ranged from 0125 to 1 0 ,Lg./ml. (mean 0 52); for tetracycline the MIC ranged from 0-125-20 ,±g./ml. (mean 075). Steigbigel, Reed, and Finland (1968a) Because these studies indicated that minocycline might fit the need for an oral antigonococcal agent effective in the form of a single dose, a clinical trial was felt to be worth while. MaterialDuring an 8-month period, 170 men presenting at the Houston Social Hygiene Clinic for treatment of a urethral discharge were selected for the study. Criteria for acceptance of these males into the study included a Gramstained urethral smear showing typical intracellular Gram-negative diplococci and a positive culture for N. gonorrhoeae. Eleven non-pregnant females with genital secretions culturally positive for N. gonorrhoeae were also included in the study. MethodUsing sterile cotton-tipped applicator sticks, urethral or cervical exudate from each subject was cultured on Thayer-Martin selective medium. The cultures were incubated in a candle jar at 37°C. and examined at 24 hours. Identification of N. gonorrhoeae was confirmed by finding Gram-negative diplococci with typical colony characteristics giving a positive oxidase reaction.Patients were treated with a single dose of minocycline and observed for 30 minutes for side-effects. The men were instructed to return within one week and the women within 2 weeks for follow-up examination and re-culture as is the routine in this clinic. On return each individual was questioned regarding sexual contact and the occurrence of any side-effects. Patients with a post-treatment positive culture result were considered to indicate therapeutic failure regardless of clinical findings. The majority of men returning did so within one week and those who did not return within 14 days were exclud...

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Section: Discussioncontrasting

confidence: 75%

Treatment of gonorrhoea with a single oral dose of minocycline.

Duncan¹,

Glicksman²,

Knox³

et al. 1971

Sexually Transmitted Infections

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“…(Duncan and others, 1971) to 4-5 per cent. (Thatcher, Pazin, and Domescik, 1970). The present study compares the efficacy of two single-dose schedules in the treatment of uncomplicated gonorrhoea in men.…”

Section: Introductionmentioning

confidence: 96%

Minocycline hydrochloride (Minocin) as a single-dose oral treatment of uncomplicated gonorrhoea in men.

Masterton¹,

Schofield²

1976

Sexually Transmitted Infections

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Summary 349 male patients with uncomplicated gonococcal urethritis were treated with a single dose of 300 mg. or 400 mg. minocycline hydrochloride.The lower dose gave a lower failure rate, 3-2 compared with 5 -1 per cent., but this difference was not statistically significant. The overall known failure rate of 4-2 per cent. compares most favourably with our previous findings in this area using other drugs ofthe tetracycline group. The incidence of post-gonococcal urethritis (5.1 per cent.) was also the lowest we have found. The few side-effects reported were comparatively trivial.Because of its high degree of therapeutic efficacy, the relative lack of side-effects, and the reduced incidence of post-gonococcal urethritis, minocycline hydrochloride should be considered the drug of choice whenever single-dose oral treatment is given in uncomplicated gonorrhoea in men. IntroductionThe increasing relative resistance of gonococci to penicillin has meant that over the years the dose has had to be increased at regular intervals to remain effective. Some centres have already used as much as 5 m.u. penicillin with probenecid to treat gonorrhoea (Gray, Phillips, and Nicol, 1970). This is thirty times the amount of the crude penicillin which gave satisfactory cure rates in the early 1940s.

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“…In view of the conflicting reports on the efficacy of minocycline for this purpose (Duncan, Glicksman, Knox, and Holder, 1971;Pariser and Marino, 1970;Thatcher, Pazin, and Domescik, 1970), a clinical trial was recently carried out at the Nottingham special treatment centre, which showed a cure rate of 94 1 per cent. in cases of uncomplicated gonorrhoea in males (Shahidullah, 1975).…”

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confidence: 99%