Ampicillin in the treatment of imprisoned patients with gonorrhoea.

It is generally acknowledged that a reduction in the sensitivity to penicillin of several gonococcal strains is leading to an increase in therapeutic failures. Since 1963 we have tentatively used ampicillin (Doctacillin 8) to treat gonorrhoea infections in patients in the Copenhagen prisons. The acid stability of ampicillin, the satisfactory absorption of the drug from the gastrointestinal canal, the fact that its free concentration in plasma is higher than that of penicillin G (owing to its reduced binding to plasma proteins), and its intensified bactericidal action on gonococcal strains with reduced sensitivity to penicillin G (Odegaard, 1962) provide the theoretical basis for the application of the drug. In the treatment of imprisoned patients the finding of positive cultures after treatment always points to therapeutic failure, whereas among out-patients it may be difficult to decide between treatment failure and re-infection (Willcox, 1964). Accordingly, the present series, in which all the patients were isolated in hospital or in prison awaiting trial, provided ideal data to assess the efficacy of ampicillin therapy.