Treatment of Gonorrhea with Trimethoprim-Sulfamethoxazole

TMP-SMZ-9, and TMP-SMZ-12 regimens were 4%, 23%, and 19%, respectively. APPG was significantly more effective (P < 0.05) than TMP-SMZ-9 or TMP-SMZ-12. Isolates of Neisseria gonorrhoeae from treatment failures as compared to those from treatment successes were significantly more resistant to SMZ (P < 0.01) and to the TMP-SMZ combination in a ratio of 19 parts SMZ to one part TMP (P < 0.05). Minimal inhibitory concentrations of SMZ, TMP, TMP-SMZ, and penicillin G showed positive correlation coefficients. The effectiveness of current regimens recommended by the U. S. Public Health Service for treatment of uncomplicated gonorrhea [1] has recently been documented [2]. Procaine penicillin G remains the standard of efficacy against which alternative regimens are judged; ampicillin provides effective oral therapy for patients who prefer nonparenteral therapy; and spectinomycin is an effective parenteral alternative for penicillinsensitive patients. Furthermore, treatment with these regimens can be completed at a single session under direct supervision. Unfortunately, although the currently recommended four-day oral course of tetracycline * HCI is highly effective, this 17-dose regimen requires substantial patient compliance at a time when many have become asymptomatic. We have therefore investigated oral regi