Treatment of Acute Gonococcal Infections in Bangkok with a Dose Range of the New Cephalosporin,Cefodizime

In this randomized dose range study conducted in Bangkok, 326 patients with presumed acute uncomplicated gonorrhoea were treated with a single intramuscular dose of either 0.25 g, 0.5 g, or 1.0 g of a new aminothiazole cephalosporin, cefodizime. One hundred and eighty men and 110 women were evaluable for efficacy. Pathogens were eliminated in all but 4 of these patients resulting in a cure rate of 99%, irrespective of dose, sex, or multiplicity of infected sites. A high percentage of the 290 strains of Neisseria gonorrhoeae isolated from the evaluable patients showed resistance to penicillin, and 40% were penicillinase producing (PPNG). The minimum inhibitory concentration of cefodizime for 90% of the PPNG strains was <0.04 mg/l. No clinically relevant adverse drug reactions were reported. This study demonstrates that a single 0.25 g dose of cefodizime is effective against both PPNG and non-PPNG strains in a geographic region characterized by high endemic antibiotic resistance.