MULTICENTER, COMPARATIVE-STUDY OF CEFOTAXIME AND CEFTRIAXONE FOR TREATMENT OF UNCOMPLICATED GONORRHEA

Background and Objectives: Cefotaxime is a third-generation cephalospo rin that has in vitro activity against Neisseria gonorrhoeae, includin g beta-lactamase-producing strains. A single 1-g intramuscular dose is effective and is recommended by the Centers for Disease Control and P revention as an alternative treatment for uncomplicated gonorrhea. Goa l of this Study: This study was conducted to evaluate the efficacy and safety of a lower 500-mg dose of cefotaxime in the treatment of uncom plicated gonococcal infections. Study Design: In a randomized multicen ter study, patients who had uncomplicated gonorrhea were treated with 500 mg of cefotaxime or 250 mg of ceftriaxone. Both antibiotics were g iven intramuscularly. Efficacy and safety were assessed four to seven days following treatment. Results: Six hundred thirteen patients were enrolled. Bacteriologic eradication rates for anogenital infection wer e 97.7% of the patients (213/218) in the cefotaxime group and 99.1% of the patients (221/223) in the ceftriaxone group (P = 0.243). Adverse events occurred in 4.2% and 7.5% of patients in the two groups, respec tively. Conclusion: Cefotaxime 500 mg appears to be a safe and cost-ef fective alternative to ceftriaxone 250 mg for the treatment of uncompl icated gonorrhea.