Detection of repeated gonorrhea by a modified follow-up method

Abstract

The rate of reinfection after treatment was studied in four groups of patients. The first group of 100 patients were evaluated retrospectively after treament with 1.0 g ampicillin twice followed by two re-examinations over a 2-week period during which time intercourse was prohibited. The second and third prospective groups consisted of 100 and 200 patients respectively, treated with 1 g ampicilin twice and 1.4 g pivampicillin + probenecid respectively, with re-examinations at intervals of 1 week and 4 weeks after treatment. In these two groups sexual intercouse was allowed during the last 10 days of the follow-up period. The fourth study group consisted of all patients infected with gonococci having MIC ≥0.3 μg/ml for ampicillin and/or benzylpenicillin, who were treated with 1 g ampicillin twice during the period of 1973-76. In the first group no positive cultures were obtained at re-examination. In groups two and three, 35 out of 300 (12%) were found to have positive cultures at re-examination. Some of these were probably treatment failures. The failure rate in group four was found to be 20%, indicating that the treatment regimen used left a narrow therapeutic margin. However, the risk of reinfection, in this urban clinic, seems to be higher than the risk of treatment failure, which would have remained undetected had sexual intercourse been forbidden.