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September 26, 1980

Treating of Anorectal Gonorrhea

JAMA. 1980;244(13):1437. doi:10.1001/jama.1980.03310130017018

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To the Editor.—  The article by Michael Sands, MD, MPH (243:1143, 1980), describes the failure rate with different regimens in treating anorectal gonorrhea. We saw failures with 2 g of spectinomycin hydrochloride and with standard doses of tetracyclines, but not with 4 g of spectinomycin hydrochloride. In treating anorectal infections with orally given tetracyclines, we supplement these effectively with tetracycline hydrochloride suppositories. The extent of these infections is anatomically limited. Patients receive four 125-mg suppositories and are told to insert them once a day. The tetracycline suppositories are not available from pharmaceutical manufacturers and have to be prepared by a local pharmacist. We have not tried to find the minimum effective number of suppositories nor their preventive value for homosexual men.