Trobicin (actinospectacin), a new injectable antibiotic in the treatment of gonorrhoea.

Numerous workers in many countries (Willcox, 1961) have reported increasing failure rates in the treatment of gonorrhoea both with penicillin and with streptomycin (Alergant, 1958). Evidence is accumulating of an increased number of strains of gonococci which are less sensitive to these antibiotics than formerly (Cradock-Watson, Shooter, and Nicol, 1958; Curtis and Wilkinson, 1958). Although "resistance" to penicillin is only relative-and failures will still respond if sufficient penicillin is given-that to streptomycin is virtually absolute (Durel, 1961; Reyn, 1961). In addition, sensitivity reactions to penicillin have become a world-wide problem in recent years (Ids0e, Guthe, and Willcox, 1958). The most effective available method of avoiding such reactions is to refrain from giving penicillin (or streptomycin) to persons known to have had previous sensitivity reactions to these antibiotics, or to persons with a history of allergy, especially of asthma. These hindrances have emphasized the need of an effective alternative drug to penicillin for the treatment of gonorrhoea. The disease can be cured by a number of antibiotics given orally, including the tetracyclines, chloramphenicol, erythromycin, spiramycin, and penicillin-but these drugs are not only considerably more costly but nearly all usually require repeated dosing. Orally administered drugs are inherently unsatisfactory for the treatment of venereal diseases as patients frequently do not take them as instructed. Moreover when the urethral or vaginal discharge has apparently subsided, they may keep the unconsumed tablets for self-medication on a future occasion (with all that this implies), and a "black market" in the tablets may be created by unscrupulous persons. Of the drugs other than penicillin which may be given by injection, chloramphenicol is out of favour