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RT.2

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RIDGE EXIT

THE 1982 MR. CLUB AKRON CONTEST

Disco

AUGUST 14th 10pm

SATURDAY

Friday

000

August 20th

ALL YOUNGSTOWN PERSONS ADMITTED FREE with valid LD.

akron, ohio

DISCO BALLROOM

419 KENMORE BLVD-phone: 216-375-5275

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25¢ Hot Dogs, Movies & Popcorn No Charge

ACTION

CLINIC

OUR BODIES, OUR MINDS: by Harvey Thompson, M.D.

"Penicillin-Resistant Gonorrhea"

When penicillin first came out in 1943, the standard dosage for treating gonorrhea was 160,000 units, and it seemed so successful that doctors predicted gonorrhea would soon be totally eradicated. But with the worldwide epidemic of gonorrhea in the '60's, along with the emergence of strains of Neisseria gonorrhea less sensitive to penicillin the treatment dose has had to be in creased to the present 4.8 million units, about 30 times the original

dose.

Why has this happened? Aside from chromosomal mutation that can change the sensitivity of gonorrhea to penicillin, there's a second way for bac teria to resist: The "R" factor. ONA particles mediate antibiotic resistance and can attach themselves to bacteria. They had been seen lurking in cell cytoplasm for years; so had other plasmids (as DNA pariticles are called) without the capacity to attach. Some far sighted geneticists went so far as to predict that some day the feared "marriage" of the antibiotic affecting DNA particle and the bacteria's chromosome would occur.

They were right. In 1976, isolates of gonorrhea were found that were resistant to the penicillin antibiotic, and thus were born a new strain: penicillinase producing gonorrhea. (The suffix "ase" denotes a breakdown or destruction.) In short, penicillin could no longer destroy those bacteria. Fortunately, the presence of the strain has never become the problem that was feared. Current health department reccomendations stick with penicillin, though tetracycline, spectinomycin and ampicillin have their individual applications. Penicillin remains in most cases, the one medication that can cure gonorrhea at the site: not always a surety with the others. The fear remains that penicillin-resistant organisms could become a problem. A substantial reservoir of resistant GC exists in the Far East, and enters the U.S. through West Coast ports. there were 87 cases, generally in the Western United States, in 1976, and 220 in 1977.

Penicillin-resistant gonorrhea often causes the same symptoms as non resistant strains. Neither doctor nor patient can tell wich variety is present. But the Center For Disease Control in Atlanta and local, state, and military health clinics monitor recovered organisms for the presence of the substance that renders penicillin inactive, which is called betalactamase. Its presence is a giveaway that the resistant strain is involved. When the resistant strain pops up, more effort is put into following up that case and its contacts. It's a necessary measure that keeps the resistant strain from spreading. Other drugs have to be used to treat these cases: Trobicin (spectinomycin).

You might ask, why not just use this drug for all cases, if it's the drug of choice for resistant gonorrhea? Well, Public Health departments deem it wise to save this medicine as a backup just for such resistant cases. The worry is that, with overuse, spectinomycin resistant strains will arise, just as has happened with penicillin.

How about tetracycline, then, the "aspirin" of the Gay community? Well, unfortunately, tetracycline has a high failure rate with the resistant strains. It continues to work well for urethral and oral infections of non resistant strains, but has never been the drug of choice for rectal gonorrhea, where it often fails.

Be reassured that the number of the resistant cases is rare in North America, and seldom appear overnight. There's no reason to panic; just be aware.

WHAT CAN YOU DO? For one thing, keep up a regular program of VD testing, especially for rectal gonorrhea, where symptoms frequently do not occur. Also insist on a culture when you are treat' ed for gonorrhea, and have followup cultures after treatment to make sure that you're cured. Be frank with your Cont. on p. 23

ACTION/21

(corner of kenmore & lakeshore blvds)