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To the Editor.—
It is time to reassess the cliché, "Penicillin remains the treatment of choice for uncomplicated gonorrhea," as recently repeated by Caldwell (218:714, 1971).There are now good arguments against the use of penicillin for uncomplicated gonorrhea.Fatal reactions to penicillin treatment for gonorrhea are noted by the authors to occur at a rate of two per 100,000. Anaphylactic reactions are estimated to occur at a rate of one to four per 10,000. These must be presumed to be potentially fatal.There were 600,072 reported cases of gonorrhea in 1970. If these cases had all been treated with the recommended doses of penicillin, there would have been 60 to 240 cases of anaphylactic reaction and six deaths due to the treatment. There was only one death due to gonorrhea in the United States in 1968, the most recently reported year, although annual deaths since 1965 have ranged
Jones PH. Treatment of Choice for Uncomplicated Gonorrhea. JAMA. 1972;219(5):619-620. doi:10.1001/jama.1972.03190310045015