Comparison of enoxacin and ceftriaxone in the treatment of uncomplicated gonorrhea

Background and objectives: The increasing prevalence of re sistant strains of Neisseria gonorrhoeae has prompted investi gation of new agents for the treatment of this sexually transmit ted disease. Goal of this study: This study compared the efficacy and safety of a single oral dose of enoxacin to intramuscular cef triaxone in the treatment of uncomplicated anogenital infection with N. gonorrhoeae. Study design: A randomized open trial was conducted at a sexually transmitted diseases clinic in Brooklyn, New York. Adults with uncomplicated gonorrhea were randomly assigned to receive 400 mg of enoxacin or 250 mg of ceftriaxone. A follow-up examination was conducted 5 to 9 days later. Results: 59 women and 23 men were enrolled; 40 women and 19 men were evaluable. Enoxacin eradicated 18 of 19 endocer- vical, 10 of 10 urethral, 5 of 5 anorectal, and 3 of 3 pharyngeal gonococcal infections. Ceftriaxone eradicated 20 of 21 endocer- vical, 9 of 9 urethral, 5 of 5 anorectal, and 2 of 2 pharyngeal gonococcal infections. Fifty-nine pretreatment isolates of N. gonorrhoeae were available for antimicrobial susceptibility testing. The geometric mean minimal inhibitory concentration was 0.03 mg/1 for enoxacin and 0.005 mg/1 for ceftriaxone. There were few side effects in either group, and both drugs were ineffective against concomitant infection with Chlamydia tra chomatis. Conclusion: Oral enoxacin appears to be a safe and effective method of treatment for anogenital infections caused by N. gon orrhoeae.