Comparison of Different Antibiotics in the Treatment of Acute Gonorrhoea in African Negroes.

Recently it has become apparent that there is a tendency for penicillin to fail in the treatment of gonorrhoea (Curtis and Wilkinson, 1958; King, 1958; Willcox, 1959). This would appear to be due to the development of resistance on the part of the gonococcus. It was decided to compare the effect in vivo of two new antibiotics using two series treated with penicillin as controls. In one control series, penicillin was given as a single dose of 1 -2 mega units containing the long-acting benethamine penicillin G (Triplopen); in the other, 2 4 mega units procaine penicillin were given in three consecutive daily doses. One of the two new drugs was actinospectacin ("Trobicin"), a derivative of which has been reported previously to be an effective treatment (Laird and Taylor, 1962; Willcox, 1962). This was given as a "single-shot" treatment, 0 * 8 g. being injected into each buttock on the same occasion. The second new drug was the orally administered "Rovamycin" (spiramycin) given in a single dose of ten tablets, very good results having been reported by Siboulet and Durel (1961). The investigator in tropical Africa is faced with many difficulties, some of which I have outlined previously (Clarke, 1951, 1960). The recent relinquishing of European control over large areas has, if anything, increased these difficulties, the political disengagement usually involving the replacement of experienced personnel by hastily-trained indigenous staff or by new and less experienced expatriates.