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Canadian Journal of Infectious Diseases
Volume 4, Issue 6, Pages 347-351
Original Article

Need for Treatment of Gonorrhea to be Effective against Chlamydia trachomatis

William R Bowie,1,2 Joanne Ast,1 Linda Sibau,1 Carol Shaw,2 Hugh D Jones,1,2 and William A Black1,2

1Divisions of Infectious Disease and Medical Microbiology, Faculty of Medicine, University of British Columbia, Canada
2Division of Venereal Disease Control and the British Columbia Centre for Disease Control, Ministry of Health British Columbia, Canada

Received 8 January 1991; Accepted 12 February 1992

Copyright © 1993 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Men and women with gonorrhea or contact to gonorrhea are frequently co-infected with Chlamydia trachomatis. To assess the importance of using treatment regimens active against both Neisseria gonorrhoeae and C trachomatis, tetracycline 500 mg orally four times daily for five days, with activity against both organisms, was compared with ceftriaxone, 250 mg once intramuscularly, with activity against only N gonorrhoeae. N gonorrhoeae microbiological failure occurred in six of 148 patients (4%) on tetracycline and zero of 85 on ceftriaxone. Microbiological failure for C trachomatis occurred in zero of 27 on tetracycline and 10 of 12 (83%) on ceftriaxone (P<0.001). In addition, 14 others on ceftriaxone had C trachomatis first isolated after treatment. When all types of microbiologialc and clinical failures are included, outcome was significantly better on tetracycline (P<0.001). Optimal treatment of patients with gonorrhea must include regimens with activity against both C trachomatis and N gonorrhoeae.