Sulfonamide resistance is an important factor in the therapy of gonorrhea and constitutes a formidable barrier in the present campaign for the complete eradication of this disease. An analysis by Cox1 of over 700 cases of gonorrheal urethritis in the male treated with sulfathiazole, sulfadiazine and sulfamerazine2 shows that 70 per cent of the cases are clinically and bacteriologically negative within five days and that the remaining 30 per cent show varying degrees of resistance. The principal manifestations of sulfonamide resistance are (1) persistence of symptoms and positive cultures for from several days to many months and (2) persistence of positive cultures in asymptomatic carriers. The latter group particularly constitute a serious public health menace.
Evidence has been reported showing that factors within the invading gonococcus determine sulfonamide resistance more than constitutional factors within the host, provided drainage is adequate and that proper therapeutic measures have been taken.
Goodale WT, Gould RG, Schwab L, Winter VG. LABORATORY IDENTIFICATION OF SULFONAMIDE RESISTANT GONOCOCCIC INFECTIONS. JAMA. 1943;123(9):547–549. doi:10.1001/jama.1943.82840440001007
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