Treatment of uncomplicated gonorrhea in men with single-dose moxalactam

Abstract

Men with uncomplicated urethral or rectal infection due to beta-lactamase-negative Neisseria gonorrhoeae were treated with single doses of moxalactam (1.0 g given intramuscularly). Urethral or anorectal infection was eradicated in 95 of 100 men who returned for follow-up visits three to eight days after treatment; four of eight pharyngeal gonococcal infections were eradicated. The geometric mean minimal inhibitory concentration of moxalactam for 119 pretreatment gonococcal isolates was 0.088 micrograms/ml (range, 0.008-1.0 microgram/ml), and gonococci isolated from homosexual men were significantly more resistant to moxalactam and penicillin G than were isolates from heterosexual men. Post-gonococcal urethritis (PGU) developed in 24 (29%) of 84 subjects who were followed for 12-30 days; 17 (71%) of the cases of PGU were due to Chlamydia trachomatis. Among 21 homosexual men with rectal gonorrhea, five (24%) had coexisting rectal infection with C. trachomatis. Moxalactam is comparable to other single-dose regimens for the treatment of uncomplicated urethral or anorectal gonorrhea in men due to beta-lactamase-negative N. gonorrhoeae.