Single-Dose Oral Therapy for Uncomplicated Gonorrhea: Comparison of Amoxicillin and Ampicillin Given with and without Probenecid

Abstract

Among men and women with uncomplicated anogenital gonococcal infection, 95% were cured by a single 3.0-g oral dose of amoxicillin, 91% were cured by 3.0 g of ampicillin, and 98% were cured by 3.5 g of ampicillin given with 1.0 g of probenecid. The distribution of minimal inhibitory concentrations of ampicillin for Neisseria gonorrhoeae was bimodal. Gonococci isolated before treatment were available from 12–16 patients with anogenital infection that persisted despite therapy, and 11 of these 12 isolates were among the more resistant population, having minimal inhibitory concentrations ⩾0.25 µg of ampicillin/ml. In contrast, seven (33 %) of 21 oropharyngeal gonococcal infections were not cured by treatment with one of these regimens, and therapeutic failure was not limited to patients harboring the more resistant gonococci. N. gonorrhoeae was recovered from the oropharynx of five additional patients after treatment. Thus, oropharyngeal infection accounted for 12 (43 %) of 28 persistent or recurrent infections in this study.