The treatment of gonorrhoea--beta lactamase producers.

The high endemicity of PPNG in some regions preclude the continued routine use of procaine penicillin as treatment for gonorrhoea. The aminoglycosides, spectinomycin, second and third generation cephalosporins are highly effective and on epidemiological grounds, should replace penicillin as the first choice antibiotic. However, due cognizance has to be given to the impact of this recommendation on the non PPNG strains and the development of chromosomal resistance to the latter antibiotics. Also, the discontinuation of penicillin as the first line drug for gonorrhoea may see a resurgence of early syphilis. All future recommendations on the treatment of gonorrhoea should take these factors into consideration. Synergetic combination of beta lactam antibiotics and beta lactamase inhibitors or combination therapy may be the lines along which future research should head.