The problem of penicillin resistant gonococci.

This is the authors' abstract. We don't add key points for this paper.

The incidence of relative resistance to penicillin among gonococci appears to have been increasing for some years.This study was undertaken in order to reassess the occurrence of penicillin resistant strains in one clinic and to correlate this with the incidence of failure of a single dose of penicillin to cure gonococcal urethritis in the male. Material and Methods ClinicalBetween August and September, 1966, 98 cultures yielding gonococci were obtained from 98 consecutive male patients in whom a diagnosis of gonococcal ure- thritis had been made by examination of stained sniears.Diagnosis, treatment, and assessment of these patients were carried out by the staff of the Venereal Diseases Department at St. Thomas' Hospital.Diagnosis was based on findings in Gram-stained urethral smears made by the clinic staff and assessment of the result of treatment was made by the same staff, who worked without knowledge of the culture results or of the penicillin sensitivity of the isolates.Treatment consisted of one intramuscular injection of 600,000 units of procaine penicillin.Patients were followed up for 3 months and serological tests for syphilis were done at the first and last visit to the clinic.If gonococci re- appeared during follow-up and the reappearance was considered to be due to relapse, then Triplopen (Glaxo) 2*5 million units was given; this preparation is a mixture of benzathine penicillin (40 per cent.),procaine penicillin (20 per cent.), and sodium benzyl penicillin (40 per cent.); it is claimed that a single dose maintains therapeutic concentrations for 3 to 4 days.If, however, the reappearance of the gonococci was thought to be due to re-infection, the routine treatment of 600,000 units of procaine penicillin was simply repeated.The distinction between relapse and re-infection is discussed later in this paper.If penicillin treatment unmasked a co-incident non-gonococcal infection, this was treated in the first instance with tetracycline 500 mg.three times a day by mouth for 5 days.