Public Health; and the Departments of Medicine,

Three hundred seventy-six patients with uncomplicated infection due to f3-lactamase-negative Neisseria gonorrhoeae were treated with 1.0 g of cefotaxime intramuscularly or with 4.8 x 106 units of aqueous procaine penicillin G (APPG) intramuscularly plus 1.0 g of probenecid, administered orally. Cefotaxime eradicated 157 (98.1 %) of 160 urethral or endocervical gonococcal infections, 22 (96070) of 23 rectal infections, and 8 (73070) of 11 pharyngeal infections. In comparison, APPG-probenecid eradicated 125 (98.4%) of 127 urethral or endocervical gonococcal infections, 17 (94070) of 18 rectal in-fections, and 4 (100070) of 4 pharyngeal infections. Of 304 domestic f3-lactamase-nega-tive gonococcal isolates, 294 (96.7%) were inhibited by ~O.03Iig/ml of cefotaxime. In a separate study, cefotaxime eradicated 31 of 31 urethral infections due to f3-lactamase-positive strains of N. gonorrhoeae acquired by U.S. Navy personnel in the Philippines. Treatment with cefotaxime was tolerated better than treatment with APPG, primarily because only one injection is required for cefotaxime. The efficacy of cefotaxime was comparable to that of APPG-probenecid in the treatment of uncomplicated genital or rectal infection due to f3-lactamase-negative N. gonorrhoeae, and cefotaxime appear