FACTORS IN THE RESISTANCE OF GONORRHEA TO SULFONAMIDES

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Abstract
Resistance to sulfonamide therapy in gonorrhea is a growing problem, occurring in 25% to 50% of cases in [male][male]. It is manifested by persistence of symptoms, persistence of positive cultures in asymptomatic carriers, or relapse after apparent cure. The resistance to sulfadiazine and sulfathiazole of 32 strains of Neissena gonorrhoeae isolated from clinical cases is detd. This is done by observing the growth of serial dilutions of the organism in the presence of varying concs. of the drugs over a given period of time. Correlation between clinical response to sulfonamides and results of the above in vitro detn. is demonstrated in all cases studied. This correlation indicates that those factors within the gonococ-cus determining in vitro resistance to sulfonamides also determine the clinical response to sulfonamide therapy. Advantages of a simplified modification of this "sulfonamide resistance typing" technique are presented the probable clinical course of a given case can be predicted at the beginning of treatment; responsive cases may be discharged early after a course of chemotherapy without fear of relapse or need for repeated re-examination; resistant cases are saved the danger of repeated useless courses of sulfonamides; and penicillin or fever therapy, both effective in sulfonamide resistant cases, may be started early if indicated by the in vitro "typing."''.