Recent Press Coverage about Drug Resistant Gonorrhea

January 24, 2014

Recent Press Coverage about Drug Resistant Gonorrhea


Several recent news stories reporting cases of the H041 strain of gonorrhea in the United States are inaccurate. The H041 strain referenced in many of these news articles refer to a case detected in Japan several years ago. The H041 strain has not been detected since then, and was never reported in the United States.

CDC is, however, concerned about the threat of drug resistant gonorrhea and continues to raise awareness on this important public health issue, but it is critical to remember that currently-recommended treatment regimens remain effective in the United States.



Gonorrhea Treatment: A Shrinking Arsenal

While antibiotics have long been successfully used to treat gonorrhea,

the bacteria has eventually grown resistant to every drug ever used

to treat it, including sulfonamides, penicillin, tetracycline, and most

recently fluoroquinolones. In 2007, due to widespread drug resistance,

CDC revised its gonorrhea treatment guidelines to no longer

recommend fluoroquinolones. This left only one class of antibiotics,

cephalosporins — which includes the oral antibiotic cefixime and the

injectable antibiotic ceftriaxone — to effectively treat the disease.

Now, evidence from CDC’s Gonococcal Isolate Surveillance Project

(GISP) suggests that cefixime is becoming less effective in treating

gonorrhea (see sidebar at right).

To date, no patients have failed treatment with either cefixime or

ceftriaxone in the United States. However, a small but growing number of

cefixime treatment failures have been observed in other countries. This

information, coupled with past experience and the latest U.S. surveillance

data, suggest that it is only a matter of time before gonorrhea becomes

resistant to the only remaining treatments currently available.

Revised Guidelines

CDC’s revised treatment guidelines are designed to ensure that patients

receive the most effective treatment for gonorrhea.

The most significant change in the new guidelines is that CDC

no longer recommends cefixime as an effective oral treatment

for gonorrhea, leaving only injectable ceftriaxone to be used in

combination with one of two oral antibiotics, either azithromycin

or doxycycline. Ceftriaxone is more potent against gonorrhea than

cefixime, and when paired with the additional oral antibiotic, might

slow the emergence of drug resistance by ensuring that gonococcal

infections are quickly cured and not allowed to spread.




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