Comparison of thiamphenicol and spectinomycin in the treatment of uncomplicated gonorrhea in men.

Thiamphenicol (2.5 g perorally) was compared with spectinomycin (2.0 g im) in the treatment of uncomplicated gonococcal urethritis in men. Patients were selected on the basis of cultures positive for Neisseria gonorrhoeae and were randomly assigned to one of the treatment regimens. Test-of-cure cultures were done three to five days after treatment. Beta-lactamase activity of every isolate was tested. In the group treated with thiamphenicol, 152 patients were followed; 63 (41.4%) failed to be cured, while the spectinomycin regimen gave a cure rate of greater than 95%. Penicillinase-producing strains gave a greater rate of failure than non-penicillinase-producing strains. The strains of N. gonorrhoeae isolated in Seoul had high minimal inhibitory concentrations of various antibiotics. About 48% of strains had a MIC of greater than or equal to 2 micrograms of thiamphenicol/ml. Hematologic examinations, repeated on days 0, 3-5, 10, and 30 of treatment, revealed no appreciable toxicity following the thiamphenicol regimen.