Spectinomycin and Penicillin G in the Treatment of Gonorrhea

Patients with uncomplicated gonorrhea received either 2.0 gm or 4.0 gm of spectinomycin hydrochloride or currently recommended doses of penicillin G procaine. Of 172 men reexamined within seven days after treatment of gonococcal urethritis, treatment failure rates were 17% for 2.4 mega units of penicillin G procaine, 0% for 2 gm of spectinomycin hydrochloride, and 3.4% for 4 gm of spectinomycin hydrochloride. Of 143 women, failure rates were 13% for 4.8 mega units of procaine penicillin G, 4.3% for 2 gm of spectinomycin hydrochloride, and 4.7% for 4 gm of spectinomycin hydrochloride. Pretreatment isolates ofNeisseriagonorrhoeaefrom patients not cured with penicillin G procaine showed increased resistance to penicillin G (P<.001).Neisseria gonorrhoeaeshows significant positive correlation of resistance to penicillin G and spectinomycin (P<.01). However, this may not be clinically important, since neither pretreatment or posttreatment isolates ofN gonorrhoeaefrom spectinomycin treatment failures showed increased resistance to spectinomycin.