Open AccessTreatment of Gonorrhea with First- and Second-generation Cephalosporins and Other New β-Lactam Antibiotics
Author(s) -
John A. Mills,
Alan Gottlieb,
William O. Harrison
Publication year - 1986
Publication title -
sexually transmitted diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.507
H-Index - 105
eISSN - 1537-4521
pISSN - 0148-5717
DOI - 10.1097/00007435-198607000-00022
Subject(s) - medicine , gonorrhea , cephalosporin , antibiotics , moxalactam , gonococcal infection , beta lactam , lactam , microbiology and biotechnology , virology , sexually transmitted disease , syphilis , human immunodeficiency virus (hiv) , biology , chemistry , stereochemistry
Aqueous procaine penicillin, ampicillin, and amoxicillin have been used successfully in treatment of gonococcal infections for many years. Many of the new beta-lactam antimicrobial agents subsequently have proved effective for treating these infections as well. First-generation cephalosporins are less active (by weight) than second-generation cephalosporins, which, in turn, are less active than third-generation drugs. Single-dose therapy of uncomplicated mucosal gonococcal infections with first-generation cephalosporins has resulted in generally unacceptably low cure rates of less than 90% in most studies, whereas parenterally and orally administered second-generation cephalosporins show good clinical efficacy. Both second- and third-generation cephalosporins are active against beta-lactamase-producing Neisseria gonorrhoeae. The extended-spectrum and ureido-penicillins are active in vitro against non-beta-lactamase-producing N. gonorrhoeae and have parallel activity in vivo. Single doses of aztreonam, the first monobactam studied in humans, have also shown excellent clinical efficacy.