Triacetyloleandomycin (Evramycin) in lymphogranuloma inguinale.

Although lymphogranuloma venereum (LGV) is a serious problem in many foreign countries, it is comparatively rare in the United Kingdom. As shown by Alergant (1957), "Somewhere between a quarter and a third of all cases of LGV reported in Great Britain are first seen"-at the Seamen's Dispensary, Liverpool. A few additional cases are treated in the other regional clinics, notably at Birkenhead, where nearly all the cases included in this survey were seen. Although the sulphonamides, tetracyclines, and chloramphenicol are established therapeutically in roughly that order, "the contradictory results obtained by different groups of investigators leave one with a sense of confusion. The bulk of the literature describing the reaction of the disease to the sulphonamides seems to favour the use of these drugs. Therefore, although I am of the opinion that buboes and proctitis respond more rapidly to... tetracyclines, . . . sulphonamides are recommended as the drugs of choice for routine therapy". (Robinson, 1952). One disadvantage of the tetracyclines in this context lies in their anti-treponemal activity. Attempts have therefore been made to find other remedies. Two such examples reported by Alergant (1953, 1961) were respectively 2 : 3 dimethyl quinoxaline, 1 : 4 dioxide (7218), which proved too toxic, and 17,025, 5 methoxy-carbonyl-6-methyl-4(5-nitrofuryl) 2: oxy 1: 2: 3: 4 tetrahydropyrimidine, which showed promise.