Sensitivity of N. gonorrhoeae to antibiotics.

Since the late thirties, physicians have been in a very fortunate position with regard to the therapy of gonorrhoea. At that time the sulphonamide drugs were discovered and produced a revolution in the treatment of gonorrhoea; when the incidence of resistant gonococcus strains became too high, penicillin came into the picture, closely followed by streptomycin and tetracycline. In addition, other antibiotics have a considerable effect on the gonococcus in vivo and in vitro (chloromycetin, erythromycin, oleandomycin, syntomycin, novobiocin, kanamycin, etc.); yet, in spite of the decreasing clinical effect and the increasing incidence of allergic response, the drug of choice has been and still is penicillin. Certain disadvantages exist for most of the other antibiotics, and they cannot be recommended, at least not for large-scale routine treatment or for use alone. Factors relevant in this connexion are: cost, method of application, toxicity, tendency to development of less sensitive or resistant strains, and selective effect on other bacteria such as the staphylococci and klebsiellae. It is well known that complete resistance to streptomycin develops very easily, and it was recently shown by Meyer-Rohn (1958) that gonococci can be made completely resistant to erythromycin and oleandomycin, and that some resistance to tetracycline can also be developed. In this paper the problems of sensitivity and treatment are considered mainly from the bacteriological point of view. The considerations are based upon work done at the Statens Seruminstitut in Copenhagen and it is not intended (to any great extent) to refer to other similar work. The gonococcus department of the Statens Seruminstitut in Copenhagen serves as a centre for the entire country, about 100,000 specimens being received each year; about 10-12 per cent. result in positive cultures, 80 per cent. being from women and 20 per cent. from men (10,000 to 12,000 positive cultures per year).