Effect of Spectinomycin Use on the Prevalence of Spectinomycin-Resistant and of Penicillinase-ProducingNeisseria Gonorrhoeae
- 30 July 1987
- journal article
- Published by Massachusetts Medical Society in The New England Journal of Medicine
- Vol. 317 (5), 272-278
- https://doi.org/10.1056/nejm198707303170504
Abstract
Because of the high prevalence of penicillinase-producing Neisseria gonorrhoeae in the Republic of Korea, spectinomycin has been used there in the primary treatment of gonococcal infections in U.S. military personnel since 1981, but there have been increasingly frequent reports of treatment failures with spectinomycin. We conducted a clinical study to determine the efficacy of spectinomycin treatment in 124 U.S. servicemen in the Republic of Korea who had urethral gonococcal infections. Ninety-seven patients were treated with spectinomycin alone and evaluated in a follow-up visit. In eight patients (8.2 percent), this treatment was unsuccessful. antibiotic-sensitivity testing on isolates from seven of the patients with treatment failure demonstrated that six isolates were highly resistant to spectinomycin (minimal inhibitory concentration, ≥100 μg per milliliter). None of the spectinomycin-resistant strains had become resistant to penicillin, either through the production of penicillinase or through a chromosomal mutation. Although the mechanism of spectinomycin resistance appears to be a chromosomal mutation, these isolates were generally sensitive to other antibiotics. The prevalence of resistance to spectinomycin resulted in the substitution of ceftriaxone for the primary treatment of gonorrhea acquired by U.S. military personnel in the Republic of Korea.Keywords
This publication has 31 references indexed in Scilit:
- Treatment of Uncomplicated Gonorrhea with CeftriaxoneSexually Transmitted Diseases, 1986
- An Unusual Case of Penicillinase-producing Neisseria gonorrhoeae Resistant to Spectinomycin in CaliforniaSexually Transmitted Diseases, 1986
- A Community-Based Outbreak of Infection with Penicillin-ResistantNeisseria gonorrhoeaeNot Producing Penicillinase (Chromosomally Mediated Resistance)The New England Journal of Medicine, 1985
- Susceptibility of Neisseria gonorrhoeae to Rifampicin and ThiamphenicolSexually Transmitted Diseases, 1984
- Effect of Treatment Regimens forNeisseria gonorrhoeaeon Simultaneous Infection withChlamydia trachomatisThe New England Journal of Medicine, 1984
- Spectinomycin resistant gonococci.BMJ, 1983
- Spectinomycin as Primary Treatment of Gonorrhea in Areas of High Prevalence of Penicillinase-producing Neisseria gonorrhoeaeSexually Transmitted Diseases, 1981
- Comparative Study of Gonococcal Susceptibility to Penicillin in the United States, 1955-1969The Journal of Infectious Diseases, 1970
- Inhibition of Protein Synthesis by SpectinomycinScience, 1965
- A procedure for the isolation of deoxyribonucleic acid from micro-organismsJournal of Molecular Biology, 1961