Thiamphenicol in the treatment of venereal diseases
Sexually Transmitted Infections
The increasing prevalence of gonorrhoea has accentuated the need for a serological diagnostic test, particularly in women with chronic or latent infections in whom cultural methods are unsatisfactory. However, a diagnostic test, to be useful, must be also highly specific and in the gonococcal field the general rule holds that increasing sensitivity is associated with decreasing specificity. While the choice of method is largely based on practical convenience, the appropriate specificity can be
... chieved only by finding suitable antigens. It is the search for these which is now occupying most workers. Results in our laboratories have shown that the choice of the gonococcal strains from which to prepare the antigen is extremely important. Urogenital infections in males can influence, more than any other disease, the psychoemotional equilibrium of patients. The severity and duration of such psychic repercussions, usually represented by depression, depend essentially on the psycho-affective constitution of the patient, but the behaviour of the physician in diagnosing and treating genital infections can play an important role in resolving or worsening psychoemotional changes. Some examples are reported in order to demonstrate the ideal behaviour of the physician in the presence of emotionally sensitive patients. 580 patients suffering from gonorrhoea (379 from the Coblenz area, Central Rhineland District, and 201 from the Hamburg area) were treated with a single oral dose of 2-5 g. thiamphenicol. Of the 379 cases (272 men, 107 women) from the Coblenz area, 374 (98-7 per cent.) were cured, and five (2 men and 3 women) (1 3 per cent.) relapsed. Of the 201 cases from the Hamburg area, 195 (97 per cent.) were cured and six (3 per cent.) relapsed. The overall results were considered very good, the total cure rate being 98-1 per cent. The success of the treatment in ten patients with gonorrhoeal epididymitis was outstanding; six patients received 2 5 g. and four received 1-5 g. thiamphenicol orally for 5 or 6 days, and all were cured. The results of treatment of seventeen patients with non-specific urethritis (1-5 g. thiamphenicol daily for 5 to 8 days) were also good; fifteen patients remained free of relapse. Serial smears and cultures for gonococci showed that the bacteriostatic effect on Neisseria gonorrhoeae of 2 5 g. thiamphenicol in a single oral dose began between the second and third hours after administration. With a single dose (2-5 g.) and repeated doses (1-5 g. daily for 6 days) of thiamphenicol, no change in the peripheral blood picture could be demonstrated even after months. With the same dosage and conditions, no effect on spermatogenesis was observed. Serial darkfield examinations of material from primary chancres showed that Treponema pallidum disappeared at the latest 72 hours after a single dose of 2 5 g. thiamphenicol, and the Herxheimer reaction did not occur after a subsequent injection of penicillin. The tolerance of thiamphenicol in the form we used was excellent. Allergies and other side-effects such as gastric disturbances and vomiting were not observed.