Perfloxacin and ciprofloxacin in the treatment of uncomplicated gonococcal urethritis in males

Abstract

Objective: To study the effectiveness of single-dose perfloxacin and ciprofloxacin in the treatment of uncomplicated gonococcal urethritis in males. Setting: Department of STD Control, Kelantan Road, Singapore. Method: 160 male patients with uncomplicated gonococcal urethritis were assigned alternately to receive single oral doses of either perfloxacin 800 mg or ciprofloxacin 250 mg. Results: Of the perfloxacin group 98.5% (65/66 patients) and of the ciprofloxacin group 98.6% (74/75 patients) were cured of gonorrhoea. The rates of post-gonococcal urethritis were 64.3% and 67.3% in the perfloxacin and ciprofloxacin groups, respectively. Both drugs were well tolerated and reported side-effects were minor and transient. There was a high incidence of penicillinase-producing gonococci (32.3%) and tetracycline resistant isolates with MIC ≥ 2 mg/l (99.3%). High level tetracycline resistance (MIC ≥ 16 mg/l) was found in 7.4% of isolates. Conclusion: The drugs in the dosages studied may be recommended for first-line treatment of uncomplicated gonococcal urethritis in males in Singapore. However, the emergence of bacterial resistance to the fluoroquinolones in the literature calls for vigilance in the monitoring of antimicrobial susceptibility.