Antibiotico-terapia in soggetti infertili con infezione uro-genitale cronica di gonococco: evidenza di differenti effetti antibiotico-mediati sull'out-put spermatico. [Antibiotic therapy in infertile subjects with chronic gonococcal infections: measurement of sperm output].

Several antibiotics of choice for the treatment of Gonorrhoea have proved to be effective in the acute forms of this disease. Men infected with gonococci may not develop or may not notice any symptoms at all: thus, complications of gonococcal infection can cause semen inadequacy and infertility. We are not aware of any previous paper on the treatment of chronic asymptomatic gonorrhoea (IUGC) and the cytotoxic effects in sperm maturation (so called "stress pattern tubular syndrome") and/or motility possibly mediated by some antigonococcal agents after prolonged period of administration. In IUGC the aims of therapy should be both the bactericidal activity and the improvement in the seminal quality. One-hundred eleven out of 785 male partners of infertile marriages were studied. They had negative post coital test and culture positive for N. Gonorrhoea in their semen. They were subdivided in six random groups and were treated with Ceftazidime (CFZ = 20 cases), Cefonicid (CFN = 20 cases) Spectinomycin (SPM = 15 cases), Aztreonam (AZT = 20 cases), Piperacillin (PP = 18 cases) and Doxycycline (DXC = 18 cases) respectively. After 7 days of treatment (C1) seminal cultures became negative in 25 cases (22.5%) and no seminal parameter showed significant variation among groups. When the treatment was repeated other twice (C3. = 1 week every month for 3 months) the antigonococcal efficacy was complete (100%), but various effects on seminal quality (Density, D; Motility, M, Oval forms, O; Sperm precursors, Sp; nemaspermic penetration depth in bovine cervical mucus PN; rate of pregnancies) were observed.