CLINICAL EFFICACY OF THE VARIOUS DRUGS USED IN THE TREATMENT OF GONORRHOEA

Authors

  • Shams -ur- Rehman
  • Amir Khan
  • Aman ullah
  • Khalid Akhter

Abstract

Background: Gonorrhoea is a purulent inflammation of mucus membrane of the genital tract andis a highly contagious sexually transmitted disease (STD) caused by the bacterium Neisseriagonorrhoae. Both men and women can be infected through a variety of sexual contact behavioursincluding vaginal, anal or oral intercourses. This comparative study was carried out in New GulailPolyclinic Jeddah, KSA from Jan 2003 to March 2004 to find the clinical efficacy ofciprofloxacin, ceftriaxone and spectinomycin, the three commonly used drugs, in the treatment ofgonorrhoea. Methods: A total number of 300 patients suffering from gonorrhoea were included inthis study. They were randomly divided into 3 groups of 100 patients each. Group-A patients weregiven Tablet Ciprofloxacin 500 mg, Group-B patients Injection Ceftriaxone 500 mg, and Group-Cpatients were put on Injection Spectinomycin 2 gm, all in stat dosage. On the 5th day following thetreatment, all patients were re-examined and their clinical and laboratory findings were recordedand analysed. Results: On the 5th day following treatment the Group-A (n=100) showed 9 (9%)partial response and 11 (11%) cases showed no response to Ciprofloxacin. In the Group-B(n=100), 4 (4%) patients showed partial response and 6 (6%) patients showed no response toCeftriaxone. In Group-C, out of 100 patients, 4 (4%) cases reported with partial response and 2(2%) patients showed no response to Spectinomycin. The efficacy of these anti-microbial agentswas the same in both the genders. Conclusion: Anti-microbial susceptibility of N. gonorrrhoeaeto various antibiotics is gradually decreasing. In order to ensure full cure, all gonorrhoea patientsshould be followed-up after a single dosage of any antibiotic. Further research should continue fornewer, effective, and preferably oral medication for the treatment of gonorrhoea.Keywords: Neisseria gonorrhoeae, sexually transmitted infection, STD, Sexually TransmittedDisease, Gonorrhoea

References

Britigan BE, Cohen MS, Sparling PF. Gonococcal infection;a model

of molecular pathogenesis. N Engl J Med 1985;312:683–94.

Woods CR. Gonococcal infections in neonates and young children.

Semin Pediatr Infect Dis 2005;16;258–70.

Barlow D, Phillips I. Gonorrhoea in women–diagnostic, clinical and

therapeutic aspects. Lancet, 1978;I(8067):761–4.

Johnson RA. Diagnosis and treatment of common sexually

transmitted diseases in women. Clin Cornerstone 2000;3(1):1–11.

Hayes RB, Pottern LM, Strickler H, Rabkin C, Pope V, Swanson

GM, et al. Sexual behaviour, STDS & risks of prostatic cancer. Br J

Cancer 2000;82:718–25.

Knapp JS, Wongba C, Limpakarnjanarat K, Young NL, Parekh MC,

Neal SW, et al. Antimicrobial susceptibilities of strains of N.

Gonorrhoeae in Bangkok, Thailand 1994-1995. Sex Transm Dis

;24(3):142–8.

Johnson SR, Morse SA. Antibiotic resistance in N. Gonorrhoeae:

Genetics and mechanisms of resistance. Sex Transm Dis

;15(4):217–24.

Zheng HP, Cao WL, Wu XZ, Yang LG. Antimicrobial

susceptibilities of strains of N.Gonorrhoeae srains isolated in

Guangzhou, China.1996–2001. Sex Transm Infect

;79(5):399–402.

Rahman M, Sultan Z, Monira S, Alam A, Nessa K, Islam S,

Antimicrobial susceptibility of N.Gonorrhoeae isolated in

Bangladesh (1997 to 1999), rapid shift to fluoroquinolone resistance.

J Clin Microbiol 2002;40(6);2037–40.

Jephcott AE. Microbiological diagnosis of gonorrhoea. Genitourin

Med 1997;73:245–52.

Su X, Hutapea N, Tapsall JW, Lind I. Plasmid-mediated resistance

of Neisseria gonorrhoeae strains isolated from female sex workers

in North Sumatra, Indonesia, 1996. Sex Transm Dis

;30(2);178–82.

National institute of Allergy and Infectious Diseases; National

institutes of Health, Department of Health and Human Services

(2001-07-20). ‘Workshop Summary; Scientific Evidence on

Condom Effectiveness for Sexually Transmitted Disease (STD)

Prevention” Hyatt Dulles Airport, Herndon, Virginia. pp 14.

Annual report of the Australian Gonococcal Surveillance Program.

, Commun Dis Intell 1999;23(7):193-7.

Herida M, Srdnaoni P, Goulet V. Gonorrhoea Surveillance System

in France: 1986–2000. Sex Transm Dis 2004;31(4):209–14.

Bhuiya BU, Rahman M, Miah MRA. Nahar S, Islam N, Ahmed M,

et al. Antimicrobial Susceptibilities and Plasmid Contents of

Neisseria gonorrhoeae Isolates from Commercial Sex Workers in

Dhaka, Bangladesh: Emergence of High-Level Resistance to

Ciprofloxacin. J Clin Microbiol 1999;37(4):1130–6.

Centers for Disease Control & Prevention. “Gonorrhoea among

men who have sex with men: 1993–96. JAMA 1997;278: 1228–9.

Ison CA, Martin IM. Gonorrhoea in London: Usefulness of First

Line Therapies. Sex Transm Inf 2002;78:106–9.

Heffernan H, Brokenshire M, Woodhouse R, MacCarthy A,

Blackmore T. Antimicrobial susceptibility among N. gonorrhoeae in

New Zealand in 2002. NZ Med J 2004;117(1191):U817.

Ng LK, Martin I, Lau A. Trends of chromosomally mediated

antimicrobial resistance in N. gonorrhoeae in Canada. Sex Transm

Dis 2003;30(12):896–900.

Collier AC, Judson FN, Murphy VL, Leach LA, Root CJ,

Handsfield HH. Comparative study on Ceftriaxone and

Spectinomycin in the treatment of uncomplicated gonorrhoea in

women. Am J Med 1984;77 (4c):68–72.

Easmon CS, Forster GE,Walker GD, Ison CA, Harris JR, Munday

PE. Spectinomycin as initial treatment for gonorrhoea. BMJ

;289 (6451):1032–4.

Ye S, Su X, Wang Q, Yin Y, Dai X, Sun H. Surveillance of

antibiotic resistance of N.gonorrhoeae isolates in China, 1993–98.

Sex Transm Dis 2002;29:242–5.

Echolas PM, Hyed A, Okeefe BJ, Schacht P. Single dose

Ciprofloxacin for the treatment of uncomplicated gonorrhoea. Sex

Transm Dis 1994;21(6)345–52.

Nissinen A, Jarvinen H, Jahkola M, Limatainen O. Antimicrobial

resistance in N. gonorrhoeae in Finland, 1976–5. Sex Transm Dis

;24:576–81.

Stapinski A, Gede K. Treatment of gonorrhoea with Spectinomycin.

Pregl Dermatol 1983;70(2):115–20.

Published

2009-03-01