Single-Dose Treatment of Uncomplicated Acute Gonococcal Urethritis in Ethiopian Men: Comparison of Rosoxacin, Spectinomycin, Penicillin, and Ampicillin

A total of 140 Ethiopian men with gonococcal urethritis were randomly assigned to treatment with aqueous procaine penicillin G (4.8 × 10⁶ units intramuscularly [im] plus 1.0 g of oral probenicid); oral ampicillin (3.5 g plus 1.0 g of oral probenicid); spectinomycin (2.0 g im); or oral rosoxacin (Acrosoxacin; 300 mg). Failure rates were 24%, 19%, zero, and 3%, respectively. Forty-four (31.4%) patients were infected with penicillinaseproducing Neisseria gonorrhoeae (PPNG) and were evenly distributed in the treatment groups. All 39 PPNG strains analyzed for plasmid content possessed a 2.6-Mdalton plasmid; 28 (71.8%) had a 3.2-Mdalton β-lactamase-encoding plasmid, ten (25.6%) had a 4.4-Mdalton plasmid (three with and seven without a 24.5-Mdalton plasmid), and one had only a 24.5Mdalton plasmid. Two patients were infected with N. gonorrhoeae-possessing plasmids apparently capable of encoding but not producing β-lactamase. Both spectinomycin and rosoxacin are excellent single-dose treatment regimens for gonococcal urethritis in men. All people receiving these drugs in Ethiopia should be tested serologically for syphilis, however, as eight (11.8%) of 68 men in this study also had active latent syphilis.