Oral Rosoxacin for Treatment of Penicillin-Resistant Gonorrhoea

The antibiotic susceptibilities of Neisseria gonorrhoeae isolates obtained from patients attending sexually transmitted disease clinics in Cholburi and Bangkok, Thailand, were determined by agar dilution. Some 28.2% of isolates produced 13-lactamase. A total of 97.9% of 13-lactamase-positive and 51% of 1-lactamase-negative isolates tested were resistant to penicillin (MICs, 22 ,ug/ml), 70%o of isolates tested were resistant to tetracycline (MICs, >2 ug/ml), and 91% of isolates tested were susceptible to spectinomycin (MICs, c64 ,ug/ml). The MICs for 90% of isolates for the other drugs tested were 2 ,ug/ml for erythromycin, 2 img/ml for cefoxitin, 1 p,g/ml for cefuroxime, 0.125 ,ug/ml for cefpodoxime, 0.06 ,ug/ml for cefotaxime, 0.25 ,ug/ml for ceftazidime, 0.03 ,ug/ml for ceftizoxime, 0.03 ,ug/ml for ceftriaxone, 0.03 ,ug/ml for cefixime, 0.06 ,ug/ml for aztreonam, 0.008 ,ug/ml for ciprofloxacin, 0.125 p,g/ml for norfloxacin, and 0.075 ,ug/ml for ofloxacin. Fewer than 1.5% of isolates were resistant to the extended-spectrum cephalosporins tested. Some 0.3% or fewer isolates were resistant to broad-spectrum cephalosporins, fluoroquinolones, or the monobactam aztreonam.

Section: Discussionmentioning

confidence: 99%

Antibiotic susceptibility survey of Neisseria gonorrhoeae in Thailand

Clendennen

Echeverria

Saengeur

et al. 1992

“…The uncontrolled availability of antibiotics has previously been cited as a confounding factor in the selection of a therapeutic regimen in and near Subic Bay and probably contributes significantly to the development and persistence of resistant strains (6). Also of interest is the presence of a P-lactamase plasmid in 55% of all strains and chromosomally mediated resistance to penicillin in 57% of the 1-lactamasenegative strains as well.…”

Section: Discussionmentioning

confidence: 99%

“…As antibiotic therapy was altered in response to the demonstration of resistance to this agent and later to others, these changes were followed by the emergence of isolates resistant to the newer therapeutic regimens (1,2,(4)(5)(6)14). Unfortunately, it also appears that once antibiotic resistance develops, it persists in the local reservoir, despite the substitution of unrelated antimicrobial agents in new antibiotic regimens (10).…”

mentioning

confidence: 99%

In vitro antibiotic susceptibilities of Neisseria gonorrhoeae isolates in the Philippines

Clendennen

Hames

Kees

et al. 1992

“…In addition, the weekly administration of 1.2 million units of benzathine penicillin for syphilis prevention in several brothel complexes may contribute to the penicillin resistance. Self-medication among sex workers in the Philippines and Thailand has been cited as contributing to the emergence of antibiotic resistance (7,21).…”

mentioning

confidence: 99%

Antimicrobial susceptibilities of Neisseria gonorrhoeae strains isolated in Surabaya, Indonesia

Joesoef

Knapp

Idajadi

et al. 1994

Until recently, the only common strains of antimicrobial agent-resistant Neisseria gonorrhoeae detected in Indonesia were penicillinase-producing N. gonorrhoeae (PPNG) strains. Despite the spread of resistance to other antimicrobial agents among N. gonorrhoeae in Southeast Asia, surveillance for such resistance in Indonesia has been limited. We evaluated the in vitro susceptibilities of 86 N. gonorrhoeae isolates from female sex workers in Surabaya, Indonesia, to 13 antimicrobial agents. Of the 86 isolates, 89% were resistant to penicillin (MIC, .2.0 jig/ml), 98% were resistant to tetracycline (MIC, .2.0 ,ug/ml), 18.1% were resistant to spectinomycin (MIC, .128.0 ,ug/ml), and 97.7% showed decreased susceptibility to thiamphenicol (MIC, 1 to 2 ,ug/ml). Thus, thiamphenicol and spectinomycin may be approaching the end of their usefulness as the drugs of choice for the treatment of gonococcal infections in Surabaya. While the susceptibilities of N. gonorrhoeae to cephalosporins (ceftriaxone, cefixime, and cefoxitin) and fluoroquinolones (ciprofloxacin and ofloxacin) are universal, these drugs have not been used because they are more expensive in Indonesia than thiamphenicol. We conclude that Surabaya had the highest reported rate of penicillin and tetracycline resistance among the Southeast Asian countries and that cephalosporins or fluoroquinolones should be reasonable alternatives for the treatment of gonorrhea in this locale.