Treatment of Non-Gonococcal Urethritis with Demethylchlortetracycline (“Ledermycin”)*†

It has been shown by several investigators that the tetracycline group comprise the most effective antibiotic therapy in non-gonococcal urethritis (NGU), although no drug or combination of drugs so far tried has been entirely successful in this condition (Harkness, 1953; Doyle, Gill, and Laird, 1957; Willcox, 1957; Leach, 1959; Csonka, 1959; and many others). Demethylchlortetracycline (DMCT) belongs to the family of demethyltetracycline which was characterized by McCormick, Sjolander, Hirsch, Jensen, and Doerschuk (1957). Important practical advantages are claimed over other antibiotics (Kunin and Finland, 1958, 1959; Finland and Garrod, 1960; Editorial, Brit. med. J., 1959). Its activity against many bacteria exceeds that of chlortetracycline by a factor of two and the antibiotic is exceedingly stable. It is much more slowly excreted than other tetracyclimes and, therefore, sustains an adequate level in the blood for a longer period. This has the advantage that only two daily doses are required and, as it has greater therapeutic activity than tetracycline, a smaller dosage should achieve the desired effect with a corresponding saving in cost. Although its antibacterial spectrum is said to be similar to that of chlortetracycline, this aspect has not yet been fully explored. It was noted that DMCT proved effective in vitro against more strains of Gram-negative bacteria commonly found in urogenital infections than did other tetracyclines (Vineyard, Hogan, and Sanford, 1959-60). From these reports, DMCT appears to be the most promising tetracycline so far available but its value can only be assessed by clinical trials. We have evaluated DMCT in NGU at two different dosage levels and have compared it with "Achromycin V" (tetracycline buffered with citric acid or sodium metaphosphate) as a representative of the tetracycline group in the dosage in current use at our two clinics.