Comparative study of ceftriaxone and spectinomycin for treatment of pharyngeal and anorectal gonorrhea
F. N. Judson, J. M. Ehret and H. H. Handsfield
Of the currently recommended regimens for treatment of uncomplicated
gonorrhea, only aqueous penicillin G procaine is effective against
infections at all sites. However, procaine penicillin is not effective
against penicillinase-producing Neisseria gonorrhoeae and suffers from poor
patient acceptability owing to the 10-mL volume of injection and allergic
and toxic procaine reactions. Ceftriaxone is a new extended-spectrum
cephalosporin with a long serum half-life and is many times more active
than penicillin G against both beta-lactamase-positive or -negative strains
of N gonorrhoeae. Ceftriaxone was compared as a single, 125-mg, 0.5-mL
injection with a single 2-g injection of spectinomycin in difficult to
treat pharyngeal gonorrhea in men and women and anorectal gonorrhea of men.
Ceftriaxone cured 30/32 (94%) pharyngeal and 52/52 anorectal infections,
compared with 6/14 (43%) and 9/9, respectively, for spectinomycin. Both
regimens were well tolerated. Ceftriaxone may prove to be a drug of choice
for uncomplicated gonorrhea, particularly where homosexual men are treated
and/or penicillinase-producing N gonorrhoeae is prevalent.