Single dose oral norfloxacin or intramuscular spectinomycin to treat gonorrhoea (PPNG and non-PPNG infections): analysis of efficacy and patient preference.

Abstract

SUMMARY Norfloxacin, a new oral quinolone, was compared with intramuscular spectinomycin for treating culture proved gonorrhoea (caused by penicillinase producing strains of Neisseria gonorrhoeae (PPNG) and non-PPNG strains.A total of 547 infected men and women were randomly allocated to treatment with either single dose norfloxacin (800 mg by mouth) or spectinomycin (2 g intramuscularly however, they are expensive and thus often beyond the means of those with low incomes, who are at greatest risk. Parenteral treatment is also less convenient to administer than oral medication and is generally less acceptable to patients. Fluorinated quinolone derivatives, such as ciprofloxacin and norfloxacin, have been developed and found to be highly effective against gonococcal infections. They produce their effect by inhibiting bacterial gyrase' and thus disturbing the replication of DNA.8As gonorrhoea is a highly transmissible disease, its quick and efficient eradication from patients is important. To that end, dose response studies with quinolones have focused on the efficacy of single dose administration. Ciprofloxacin is effective in a single dose for treating infections with non-PPNG strains,9whereas single dose enoxacin can cure infections with both non-PPNG and PPNG strains in a population with a low incidence of PPNG.' Norfloxacin in single dose has been shown to cure non-PPNG and PPNG 235 on 1 May 2019 by guest. Protected by copyright.

Emergence of in vitro resistance to fluoroquinolones in Neisseria gonorrhoeae isolated in Japan

“…Fluoroquinolones demonstrate excellent in vitro activities against Neisseria gonorrhoeae strains, including penicillin-and tetracycline-resistant strains, and are highly effective in oral single-dose treatments of gonococcal infections (1,17,20). Treating gonorrhea with fluoroquinolones is one of the regimens recommended by the Centers for Disease Control and Prevention in the United States (4).…”

Treatment of genitourinary tract infections with fluoroquinolones: clinical efficacy in genital infections and adverse effects

“…Infections caused by penicillinase-producing N. gonorrhoeae strains (3,4,9,11,15,27,30,38,39,46,48,50,55,56,60) and strains with chromosomally mediated resistance to penicillin (11) responded similarly to those caused by penicillin-susceptible strains.…”

The Role of Fluoroquinolones in Sexually Transmitted Diseases

“…Furthermore, the drug successfully cured 98.3% of infections due to PPNG in 472 subjects. ": [67][68][69] Most of the experience was in patients with urethral or cervical infections with greater than 95% microbiologic cure rates ( Table 6). The agent was 100% effective in curing rectal In one of the first reports, from the Philippines, a two-dose regimen of norfloxacin was similar to single-dose spectinomycin in men with gonococcal ureth ritis.…”