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Results of treatment of uncomplicated urogenital gonorrhea caused by penicillinase- and non-penicillinase-producing Neisseria gonorrhoeae were compared. In The Hague treatment consisted of thiamphenicol (2.5 g given orally), whereas the treatment in Rotterdam was cefotaxime (1 g given im). All isolates were tested for production of penicillinase and sensitivity to cefotaxime and thiamphenicol. Special attention was given to possible hematological effects of treatments with thiamphenicol. Of 55 patients treated with thiamphenicol, 87.3% were cured; however, all of 55 patients treated with cefotaxime were cured. The frequency of postgonococcal urethritis among male patients was 34.1% after thiamphenicol and 39.5% after cefotaxime treatment. The only adverse effect seen after cefotaxime treatment was a rash (2%). After treatment with thiamphenicol, 10.9% of patients had diarrhea. No significant changes in hematologic tests were seen after treatment with thiamphenicol. There was a remarkable and significant difference in sensitivity to thiamphenicol between the two treatment groups; this fact could point to the importance of specific local factors in comparison of different treatments for gonorrhea.

The authors studied the prevalence of genital microorganisms among 300 female prostitutes in brothels in New York City and 60 female prostitutes attending a sexually transmitted diseases clinic in Rotterdam, The Netherlands. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in the two cities were 9.3% and 8.3%, 25.3% and 16.6%, 57.3% and 74.9%, and 73% and 79%, respectively. Trichomonas vaginalis was detected in 3.6% of New York prostitutes and in 16.6% of those in Rotterdam. Nonspecific vaginitis was found in 33% of prostitutes examined in New York. In New York, Asian prostitutes were more likely to be infected with C. trachomatis (33 of 102; 32.3%) than were prostitutes of other ethnic backgrounds (44 of 194; 21.5%; P less than .05.

Two men who acquired acute gonococcal urethritis in The Netherlands and who were treated with cefuroxime (1.5 g given intramuscularly) failed to respond to this therapy. Pre- and post-treatment isolates of Neisseria gonorrhoeae from these patients had MICs of 0.5 and 1.0 microgram of cefuroxime/ml.