The antigonococcal activity of the quinolone derivative flumequine was evaluated. Of 246 strains examined, 240 (97.5%) strains showed minimum inhibitory concentrations (MICs) of flumequine of less than or equal to 0.4 microgram/ml, including three beta-lactamase-producing strains. The six remaining strains showed MICs from 3.2 to 9.6 micrograms/ml. By disc diffusion tests using 3-micrograms discs of flumequine the zones of growth inhibition correlated well with the MICs of flumequine. The effect of treatment with flumequine was compared in 239 patients with uncomplicated gonorrhoea. A single dose regimen of 1200 mg flumequine orally, a two-dose regimen of 1200 and 800 mg, and a three-dose regimen of 1200, 800, and 800 mg (six hours apart) were given. With a single dose of flumequine the failure rate was 26%. The two-dose and three-dose regimens were equally effective with an overall cure rate of 95.4%. In patients harbouring beta-lactamase-producing gonococci the infection was cured. The failures (10 men) included all of the six patients infected with flumequine-resistant gonococci. Side effects were noted by 14.6% of the patients and were mostly described as dizziness.
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