Susceptibility of Neisseria gonorrhoeae to cefotaxime: in vitro studies and treatment results

Abstract

More and more beta-lactamase-producing, penicillin-resistant strains of Neisseria gonorrhoeae are nowadays isolated in most parts of the world including the European continent. Therefore, there is a need for reliable alternatives in the treatment of gonorrhoea. Cefotaxime--first representative of a new generation of beta-lactamase-resistant cephalosporins--was evaluated for this reason, first in vitro and then in vivo. All 191 strains tested proved susceptible, the highest MIC amounting to 0.03 microgram/ml, a drug concentration well exceeded in plasma for more than 4 h after i.m. application of 0.5 g cefotaxime. In contrast to other investigators we have therefore decided to test this relatively small dose clinically without the addition of probenecid. The clinical results were excellent: 146 of 151 patients (96.7%) were cured. In the female sub-group (34 patients) the cure rate amounted to 100%. Thus, the i.m. injection of 0.5 g cefotaxime as a single dose must be looked upon as a reliable regimen for the cure of uncomplicated gonorrhoea, both in males and females.