Postgonococcal urethritis (PGU) occurred in nearly two thirds of men with gonorrhea acquired in the Far East who were "successfully" treated with 2,400,000 units of procaine penicillin G plus probenecid. PGU occurred less often after treatment of gonorrhea with tetracycline hydrochloride, and PGU itself responded to tetracycline, suggesting a microbial etiology for the condition. The syndrome was associated to a highly significant degree with Mycoplasma infection of the urethra, and occurred more often after infection with Neisseria gonorrhoeae of lessened penicillin sensitivity. The high incidence of the syndrome, one of the most common infectious diseases among military personnel in the Far East, requires a reexamination of the traditional use of penicillin in the treatment of gonorrhea in men.
Holmes KK, Johnson DW, Floyd TM, Kvale PA. Studies of Venereal Disease: II. Observations on the Incidence, Etiology, and Treatment of the Postgonococcal Urethritis Syndrome. JAMA. 1967;202(6):467–473. doi:10.1001/jama.1967.03130190073009
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