TREATMENT OF UNCOMPLICATED GONOCOCCAL-INFECTION WITH TRIMETHOPRIM-SULFAMETHOXAZOLE

The efficacy of trimethoprim-sulfamethoxazole (TMP-SMA; 80 mg of TMP and 400 mg of SMZ/tablet; tablets taken once daily for 3 days; total, 27 tablets) was compared with the U.S. Public Health Service recommended regimen of 2 g of tetracycline daily for 5 days for the treatment of uncomplicated genital gonorrhea. Fourteen (3%) of the 461 patients treated with tetracycline and 24 (5%) of the 477 patients treated with TMP-SMZ failed to be cured; the difference between the 2 groups was not significant. Treatment of patients with TMP-SMZ was more likely to fail if the isolates of Neisseria gonorrhoeae had MIC [minimal inhibitory concentration] of .gtoreq. 0.5 .mu.g of TMP/ml and .gtoreq. 9.5 .mu.g of SMZ/ml. Adverse effects were more often reported by patients receiving TMP-SMZ. Thus, TMP-SMZ is an effective therapy for uncomplicated gonococcal infections in men and women and may also eliminate agents causing postgonococcal urethritis. The utility of this drug combination may be limited by the adverse effects that are associated with the large dose used.