TRIAL OF MINOCYCLINE GIVEN AFTER EXPOSURE TO PREVENT GONORRHEA

In a prospective evaluation of antibiotic prophylaxis against gonorrhea, 1080 men were given 200 mg of oral minocycline or placebo after sexual intercourse with prostitutes in a Far Eastern port. Later, at sea, gonococcal infection was detected in 57 of 565 men given placebo and 24 of 515 men given minocycline (P<0.001). Minocycline prophylaxis completely prevented infection by gonococci susceptible to 0.75 μg or less of tetracycline per milliliter, reduced the risk of infection or prolonged the incubation period in men exposed to gonococci susceptible to 1.0 to 2.0 μg per milliliter, but did not prevent infection or prolong incubation in men exposed to gonococci resistant to 2.0 μg. Minocycline did not increase the proportion of asymptomatic infections. Minocycline prophylaxis would probably have limited effectiveness as a public-health measure because of the tendency to select resistant gonococci. (N Engl J Med 300:1074-1078,1979) PUBLIC-HEALTH programs to control gonorrhea emphasize selective culture examination of asymptomatic women, early diagnosis of symptomatic infection, adequate treatment of established cases and identification and treatment of recently exposed sex partners. Other available measures for prevention of gonorrhea include education, genital hygiene and antisepsis, use of the condom, vaccine development, topical antimicrobial prophylaxis and systemic antimicrobial prophylaxis. Limited data are available concerning systemic antimicrobial prophylaxis for prevention of gonorrhea. Prophylactic oral sulfathiazole1 was used briefly by the United States military shortly before the emergence of sulfonamide-resistant strains of Neisseria gonorrhoeae. In placebo-controlled studies conducted shortly after World War II,. © 1979, Massachusetts Medical Society. All rights reserved.