It has been shown by sensitivity testing in vitro that the effect of ampicillin on most gonococcal strains is somewhat weaker than that of penicillin G, but the effect on strains less sensitive is better with ampicillin than with penicillin G. Reyn and Bentzon (1968), in support of this, found that the 50 per cent. inhibitory concentrations for the naturally-occurring more sensitive strains were about twice as high with ampicillin as with sodium penicillin G, whereas an opposite tendency was observed in the less sensitive strains.As the great majority of relapses after treatment with penicillin occur in patients infected with gonococci with reduced sensitivity to penicillin, it is therefore possible that ampicillin could be an effective remedy in the treatment of gonorrhoea. This has proved to be the case. Willcox (1963) found a failure rate of 11 9 per cent. in male patients with uncomplicated gonorrhoea treated with a single oral dose of 0 5 g. ampicillin, which proved comparable to the results achieved with single injections of aqueous procaine penicillin. Willcox (1964) ampicillin combined with one simultaneous injection of 600,000 units procaine penicillin the relapse frequency was 3 per cent., whereas 500 patients *Received for publication February 18, 1969. treated with procaine penicillin only showed a relapse rate 11-6 per cent.Probenecid, which impedes the excretion of penicillin from the body and thus causes a higher serum concentration and a longer duration of penicillinaemia, was given, together with an intramuscular injection of sodium penicillin G, to gonorrhoea patients by Jensen, Kvorning, and Norredam (1963) Roholt (1965), can give an initial penicillinaemia of up to 200 units/ml., and after 8 hours, an average concentration of 5 units/ml. Of the 832 patients treated, there were only eight who relapsed; all had had sexual intercourse after the first treatment and all were cured after a repetition of the treatment. It is therefore highly probable that these cases were not relapses but re-infections and that the cure rate was 100 per cent.We have not been able to find any publication describing the use of an oral dose of ampicillin and probenecid combined in the treatment of gonorrhoea. The object of this paper is to show the results of such treatment.
Material and Methods