c. Diagnosis. Follow this procedure:
History. Establish all sexual contacts.
Physical examination. Rectal, pelvic, and oral examination should be
(3) Laboratory test. A laboratory culture and a microscopic analysis of the
discharge from the reproductive organs, rectum, or throat.
(4) Laboratory test. The infecting organism can be isolated by a culture
from the site of the infection (the urethra, cervix, rectum, or pharynx). This culture is
grown on a Thayer-Martin or Trans-grow medium. A gram-stain smear of ureteral
discharge allows rapid identification of gonococcus in males. The cervical gram-stain,
however, is only about 60 percent reliable in women.
d. Treatment for Uncomplicated Gonorrhea.
Antibiotic therapy. One medication or a combination of medications may
(a) Give 1 gram of probenecid (Benemid) by mouth to block penicillin
from being excreted by the body. Thirty minutes later administer 4.8 million units of
aqueous procaine penicillin injected at two separate sites in a large muscle mass.
(b) If the patient is allergic to penicillin, give tetracycline TCN
(Tetracyn ) in the dosage 500 mg by mouth four times a day for five days.
(c) Another medication for the patient allergic to penicillin might be an
ampicillin such as Omnipen or Polycillin) or amoxicillin by mouth. Either medication
should be given with 1.0 gram Probenecid (Benemid). These drugs are less effective
than other forms of treatment.
(d) Spectinomycin (Trobicin) in the dosage of 2.0 grams given in a
large muscle mass may also be substituted for penicillin.
(2) Sexual abstinence. Advise the patient to abstain from sexual activity
until his cure is confirmed. Warn the patient that he is still contagious and can transmit
the gonococcal infection until he is pronounced cured.
Male restraint. A male should not "milk" the penis for urethral discharge.
Probenecid (Benemid) raises the blood levels of the penicillin given a
gonorrhea patient and prolongs the blood level concentrations by inhibiting
excretion in the kidney.