Single-dose oral treatment of gonorrhea in men and women, using ampicillin alone and combined with probenecid.

Bro-Jorgensen, A; Jensen, T

doi:10.1136/sti.47.6.443

Cited by 14 publications

(4 citation statements)

References 10 publications

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“…As discussed in a review by Sparling (24), many studies have shown that high doses of penicillin or ampicillin, combined with probenecid, will produce high cure rates despite the frequent appearance of gonococcal isolates resistant to 0.5 ,ug of penicillin (8,9,11,12,15) (19,24). It is not known whether gonococcal isolates resistant to 2.7 ,ug of ampicillin per ml would yield a significant number of failures after treatment by the USPHS-recommended 3.5 g of ampicillin plus probenecid.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Disk Susceptibility Tests with Neisseria gonorrhoeae

Maier

Beilstein

Zubrzycki

1974

Antimicrob Agents Chemother

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We have used a standardized disk diffusion procedure to test the susceptibility of 892 isolates of Neisseria gonorrhoeae to six antibiotics. The disk diffusion test described is a modification of the disk test of Bauer, Kirby, Sherris, and Turck, which is widely used for susceptibility testing of fast-growing, aerobic pathogens. With all six antibiotics (penicillin, ampicillin, tetracycline, erythromycin, chloramphenicol, and cephaloridine), disk test results were found to be reproducible and correlated well with the minimal inhibitory concentration as determined by an agar dilution procedure. The coefficients of correlation ranged from -0.79 with cephaloridine to -0.93 with penicillin. The technique described for disk susceptibility testing of gonococci can be used both for research and clinical purposes.

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Section: Discussionmentioning

confidence: 99%

Antibiotic Disk Susceptibility Tests with Neisseria gonorrhoeae

Maier

Beilstein

Zubrzycki

1974

Antimicrob Agents Chemother

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“…Populations, methodology and outcome measures were heterogeneous. Most studies were in healthy volunteers 12 , 14 , 16 , 19 , 20 , 23–25 , 27 (9/18; 50%) or in patients with gonococcal infection 13 , 15 , 17 , 21 , 22 , 26 (6/18; 33%). Additional studies reported on patients with bronchiectasis (1/18; 6%), 11 biliary pathology (1/18; 6%) 18 and invasive Staphylococcus aureus infection (1/18; 6%).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 6/18 (33%) studies reporting on treatment failure as a primary outcome, 4/6 (67%) were included in a meta-analysis comparing the addition of probenecid to an oral β-lactam antibiotic of the same dose on treatment outcome (Figure 2 ). 15 , 17 , 21 , 26 One study (17%) could not be included as different doses of ampicillin were used in the intervention and control arms. 13 A further study (1/6; 17%) could not be included due to different dosing schedules between intervention and control arms.…”

Section: Resultsmentioning

confidence: 99%

Addition of probenecid to oral β-lactam antibiotics: a systematic review and meta-analysis

Wilson

Arkell

Riezk

et al. 2022

Journal of Antimicrobial Chemotherapy

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Objectives To explore the literature comparing the pharmacokinetic and clinical outcomes from adding probenecid to oral β-lactams. Methods Medline and EMBASE were searched from inception to December 2021 for all English language studies comparing the addition of probenecid (intervention) with an oral β-lactam [flucloxacillin, penicillin V, amoxicillin (± clavulanate), cefalexin, cefuroxime axetil] alone (comparator). ROBINS-I and ROB-2 tools were used. Data on antibiotic therapy, infection diagnosis, primary and secondary outcomes relating to pharmacokinetics and clinical outcomes, plus adverse events were extracted and reported descriptively. For a subset of studies comparing treatment failure between probenecid and control groups, meta-analysis was performed. Results Overall, 18/295 (6%) screened abstracts were included. Populations, methodology and outcome data were heterogeneous. Common populations included healthy volunteers (9/18; 50%) and those with gonococcal infection (6/18; 33%). Most studies were crossover trials (11/18; 61%) or parallel-arm randomized trials (4/18; 22%). Where pharmacokinetic analyses were performed, addition of probenecid to oral β-lactams increased total AUC (7/7; 100%), Cmax (5/8; 63%) and serum t½ (6/8; 75%). Probenecid improved PTA (2/2; 100%). Meta-analysis of 3105 (2258 intervention, 847 control) patients treated for gonococcal disease demonstrated a relative risk of treatment failure in the random-effects model of 0.33 (95% CI 0.20–0.55; I2 = 7%), favouring probenecid. Conclusions Probenecid-boosted β-lactam therapy is associated with improved outcomes in gonococcal disease. Pharmacokinetic data suggest that probenecid-boosted oral β-lactam therapy may have a broader application, but appropriately powered mechanistic and efficacy studies are required.

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“…Unexpectedly, no case of ampicillin rash was encountered. Br0-Jorgensen and Jensen (1971) in Denmark. These high cure rates may not be achieved in other countries, or indeed in the large conurbations of the U.K., because of the varying incidence of highly insensitive strains of N. gonorrhoeae.…”

Section: Resultsmentioning

confidence: 99%