1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

COMPARING GONORRHEA TREATMENTS IN PREGNANT WOMEN.

Current recommendations from the Centers for Disease Control for treating gonorrhea have not been evaluated in pregnant women. This unblinded randomized trial compared three regimens -- intramuscular ceftriaxone (250 mg), IM spectinomycin (2 g), and oral amoxicillin (3 g) plus 1 g of oral probenecid -- in 252 pregnant women with culture-proven gonorrhea.

The overall efficacy of the three treatments did not differ significantly (95 percent each for ceftriaxone and spectinomycin versus 89 percent for amoxicillin plus probenecid), and cure rates did not differ significantly by infection site. However, among patients with rectal gonorrhea, only 23 of 27 patients given amoxicillin were cured (85 percent), as compared with 21 of 22 ceftriaxone- treated patients (95 percent) and all 19 spectinomycin- treated patients (100 percent). The only side effect observed was in a woman who vomited after the amoxicillin regimen. The incidence of malformations in offspring did not differ among treatment groups.

Because of its slightly lower cure rate, the authors do not recommend amoxicillin with probenecid for treating gonorrhea in pregnancy. A larger trial that includes more cases of rectal gonorrhea is needed to confirm this conclusion.

— CDM

Published in Journal Watch General Medicine January 12, 1993

Citation(s):

Cavenee CR et al. Treatment of gonorrhea in pregnancy. Obstet Gynecol 1993 Jan 81 33-38.

• Medline abstract (Free)