[Results of a comparative therapeutic trial of single-dose treatment of non-complicated acute male gonorrhea]. / Résultats d'un essai thérapeutique comparatif pour le traitement en une prise de la gonococcie masculine aiguë non compliquée.

A single dose treatment trial with: spectinomycine 2 g, ampicilline + probenecide 3.5 g + 1 g, thiamphenicol 2.5 g, minocycline 300 mg was undertaken. Three teams were involved, epidemiologists clinicians, microbiologists, 636 patients were included, 483 resumed for control. A negative culture on the third day was considered a success. Failure rates were: spectinomycine 4%, ampicilline-probenecide 3%, thiamphenicol 4%, minocycline 3%. No significant difference was noted between the four rates. The delay of clinical cure was 1.98 days for spectinomycin, 1.87 days for ampicilline - probenecide, 2.16 days for thiamphenicol and 2.12 for minocycline without significant difference. When side effects were analysed, 10% of the patients reported asthenia without difference between the four treatments. Thiamphenicol is responsible for diarrhea 28%, P less than 0,01 minocycline more significantly responsible for guidiness 13%, P less than 0,001, and 18% treated by spectinomycine complained of pain at the time of injection. The antibiotics MIC's are studied. After the analysis of the results, the cost, and the resistances, one treatment was selected.

[Present sensitivity of Neisseria gonorrhoeae in the Paris area. Results of a comparative therapeutic trial]. / La sensibilité actuelle de Neisseria gonorrhoeae en région parisienne. Résultats d'un thérapeutique comparé.

From September 1978 to September 1979, the Authors determined the M. I. C. of 16 antibiotics against 420 Neisseria gonorrhoeae strains collected in Paris area, with standard gel dilution technic. These strains remain susceptible to the greatest proportion of antibiotics tested, except streptomycin. It has been noted, however, that sensibility of a certain percentage of strains, has decreased for penicillins, cyclins, macrolides. Some strains producing beta-lactamase has been identified. Authors compared results given by the gel dilution method to those given by the diffusion or so-called "disc" method. This shows no correlation between radius of inhibition and M. I. G., with no reliable criteria to estimate the area of inhibition. Also, four protocols for therapy were followed: spectinomycin, ampicillin-probenocid, thiamphenicol, minocyclin. The patients were surveyed by physical examination and bacteriological tests. No statistically significant differences could be noted between these four protocols. However, considering the size of the samples, it is not possible to conclude. The authors reassess the necessity to survey the drug-sensitivity of Neisseria gonorrhoeae strains, in each geographical area, following an internationally agreed method. They also conclude to the necessity to compare in vitro sensitivity tests with therapeutic schemes suggested by usual sensitivity to main antibiotics.