To the Editor.
—A recent editorial in JAMA states that "Neither the penicillins nor the tetracyclines should continue to be used routinely as sole treatment for uncomplicated gonorrhea...."1 This conclusion is based on a companion article that, for the first time, documents the resistance patterns of antimicrobial-resistant Neisseria gonorrhoeae in centers across the United States.2In view of the high prevalence and wide distribution of penicillin-resistant N gonorrhoeae in the United States, the use of penicillin as a first-line treatment of gonococcal ophthalmia is difficult to justify. Further, it is particularly important for clinicians to be made aware of this possible lack of efficacy of penicillin in the treatment of a disease that is now uncommon in this country but still associated with blinding consequences.Ceftriaxone sodium must be considered the drug of choice in the treatment of both adult and neonatal gonococcal ophthalmia. Efficacy has been established
Parker JS, Gottsch JD. An Update on the Treatment of Gonococcal Ophthalmia. Arch Ophthalmol. 1991;109(5):613–614. doi:10.1001/archopht.1991.01080050019009
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