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Gonorrhea treatment has become a problem in most parts of the world and valid recommendations regarding treatment are an important control tool. In Central African Republic genital gonorrhea is one of the most common communicable diseases. In 1981 Penicillinase Producing Neisseria Gonorrhea (PPNG) was 1st isolated and, in spite of control measures, its prevalence reached 12% by the end of 1982. Effective and inexpensive treatment regimens are now needed as an alternative to the Procain Penicillin + Probenicid regimen currently in use. Since its introduction, many authors in industrialized countries have reported excellent results with Thiamphenicol (TAP) in the treatment of gonococal infections, particularly in the single dose oral treatment. Gonococcal infections caused by Penicillinase Producing Neisseria gonorrhea (PPNG) also responded favorably to the antibiotic. However, few careful studies were done in Africa. This study evaluates the efficacy of TAP compared with the standard regimen of Aqueous Procain Penicillin + Probenicid in the treatment of uncomplicated genital gonorrhea in men in Central African Republic. 380 such cases were used. Patients with coexisting genital ulcers and those treated with antimicrobics within the last 2 weeks were excluded. Gram stained smears were examined and a urethral swab was taken and cultured on a modified Thayer Martin medium. Blood specimens were collected for VDRL and TPHA tests. During a 3-month period 338 patients were treated with a positive pretreatment culture for N. gonorrhea. 242 (71.6%) presented at follow-up, with similar follow-up rates in both treatment groups (25 mg. Thiamphenicol and Aqueous Procain Penicillin G. + 1g. Probenicid). All failures but 1 in the APPG treatment group were due to PPNG infections. All of those cases were treated with Thiamphenicol regimen, 4 were cured and 6 lost for follow-up. Of 12 PPNG infections treated with Thiamphenicol, only 1 failed treatment and was cured with spectinomycin. Only few and mild side effects (diarrhea or dizziness) resulted from treatment. Thiamphenicol in single oral regimen is a low cost, effective therapy for uncomplicated gonococcal infection in males in the Central African Republic and may become potentially one of the recommended regimens if the prevalence of PPNG continues to increase.
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PMID:Thiamphenicol in treatment of genital gonorrhoeae in Central African Republic. 1234 Jan 81

Often reasons of drug allergy are local anaesthetics. True allergic reactions are presented by the contact allergic dermatitis (the 4th type of allergic reaction, mediated by sensitized G-lymphocyte), while the reactions of instant type such as anaphylactic one can be observed rarely. So, if the drug allergy is clinically presented by contact allergic dermatitis, Novocain can be replaced by Lydocaine as they don't have similar chemical structure (the same antigenic features). However, in case of the anaphylactic (pseudo allergic) reactions, the main focus become the general mechanisms of local anaesthetic effects (instant toxic effect which are the same as Novocain, Lydocaine and all other local anaesthetics. This is why in case of anaphylactic reaction the substitution of Novocain by Lydocaine is not recommended. When conducting a skin test, if the drug which had caused an allergic reaction has not been identified, it is better to use the drug of the 2nd group. During the last 14 years the allergy department in the Central Clinic of TSMU, after negative skin tests (prick-test) on local anesthetics we conduct provocation tests on local anaesthetics which contain vasoconstrictive substance adrenaline (Ultracaine, Ubistezine, etc ). In 2008 this test was conducted with 1125 patients. Only in two cases the allergic reactions were observed in the form of edema and hyperemia of mucous membrane, headache and dizziness. In case of use of these drugs the system allergic reactions were not observed. So, the sublingual provocation test is a safe and reliable diagnostic test which prevents heavy system reactions, which correlates with data given by V. Pytski. Although measurable test, pre-medication, desensitization in most cases gives us the opportunity to prescribe the proper medicine, we should not forget about potential danger of reaction appearance and be ready to relief the symptoms rapidly. In addition, we should not forget about juridical, forensic aspects and, in particular, medical card must include informational agreement, precisely documented necessity of medical procedure, and respective consultations of specialists.
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PMID:[Main principles of pathogenesis, diagnostics and prevention of drug allergy caused by local anaesthetics]. 1935 25