The charts of 606 men with anorectal gonorrhea infections treated using the current Public Health Service recommendations were reviewed. There were 3.3% failures in the group treated with penicillin—14.4% in those treated with tetracycline hydrochloride, 14.8% in the ampicillin trihydrate group, and none among those treated with spectinomycin hydrochloride. The intramuscular (IM) injection of penicillin G procaine, 4.8 million units, with 1 g of probenicid given orally is the treatment of choice for anorectal gonorrhea. An IM injection of 2 g of spectinomycin hydrochloride was effective but should be reserved for patients allergic to penicillin and for penicillin treatment failures.
(JAMA 243:1143-1144, 1980)