Biomedical subjects
Publications and source records attributed to F Gilliet.
Since the appearance of totally resistant, penicillinase producing gonococci, penicillin should no longer be considered first choice in the treatment of acute gonorrhea. In order to limit further extension of resistant strains, thiamphenicol (Urfamycin 2,5 p.o. or 0,75 i.m.) or spectinomycin (Trobicin 2,0 i.m.) are suggested as replacements for penicillin.
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A locally increased incidence of plantar warts in schoolchildren was demonstrated statistically, although the origins and causes of the epidemic remain unclear. Excessively sweating feet rather than barefoot gymnastics in school, and perhaps the wearing of rubber boots or nylon stockings appear to facilitate the infection. The use of a public swimming pool may be a possible cause, but could not be proven. It seems that an intact, thickened, dry horny layer provides some protection whereas a softened, moistened and macerated horny layer promotes the spread of plantar warts.
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Results following treatment of acute gonorrhea with aqueous penicillin combined with probenecid and spectinomycin hydrochloride (2.0 g) are compared and found to be statistically equivalent. Therefore, if a patient is allergic to penicillin, spectinomycin hydrochloride can be regarded as a valuable alternative. The results appear to be the same whether probenecid is administered simultaneously or 1/2-2 h before penicillin. It is advisable to control all patients one week after therapy. A second control after 2 weeks for men and after the next menstruation for women is highly desirable. If the patient fails to respond to treatment, not only an increase in the antibiotic dose, but also prolongation of therapy by administering the same dose on 3 consecutive days, is effective.
In the presence of penicillin allergy early syphilis can be treated with tetracyclines, erythromycin and thiamphenicol. Treatment with semisynthetic penicillins or cephalosporins should not be attempted in view of possible cross-sensitivity. From comparison of different antibiotic treatment schedules in the literature a time-dose relationship seems evident: within therapeutic limits, treatment with a high daily dose of antibiotic requires a relatively short duration, and vice versa. Results of various treatment schedules with different antibiotics suggest that preference should be given to doxycycline by oral route, 100 mg twice daily for 12 days.
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