Gonococcal Tenosynovitis-Dermatitis and Septic Arthritis

To the Editor.— Regarding the recent report of Thompson et al (1980; 244:1101) describing a randomized trial of either aqueous crystalline penicillin G potassium, 1 megaunit every eight hours intravenously (IV) (total dosage, 8 million units/day) for three days, or erythromycin stearate or estolate, 0.5 g every six hours for five days, in the treatment of gonococcal tenosynovitis or arthritis, a statement was made that no previous controlled therapy study of these common syndromes had been found. The authors had failed to note in their review of publications on the treatment of these conditions a double-blind randomized trial that had appeared several years earlier inThe Journal(1976;236:2410). Trentham et al tested whether high-dose penicillin G potassium was necessary for the treatment of gonococcal arthritis. In that study, all patients received 600,000 units of aqueous penicillin G procaine intramuscularly every 12 hours for up to ten days and either 10