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The gonococcus has now developed high-level ceftriaxone resistance, as described in this abstract from the 19th Biennial Conference of the International Society for Sexually Transmitted Diseases Research. Here also is last week’s MMWR report on emerging cephalosporin resistance in Neisseria gonorrhoeae. The upshot of the CDC recs: treat cefixime failure with the combination of IM ceftriaxone (250 mg) + oral azithromycin (2 gm). Report ceftriaxone treatment failures to CDC and “consult with an infectious diseases expert and CDC regarding re-treatment”. I guess since I’m an “infectious diseases expert” I’d better start thinking about what I’d advise (as the MMWR piece points out, “no other well-studied and effective antibiotic treatment options or combinations currently are available”).
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The gonococcus has now developed high-level ceftriaxone resistance, as described in this abstract from the 19th Biennial Conference of the International Society for Sexually Transmitted Diseases Research. Here also is last week’s MMWR report on emerging cephalosporin resistance in Neisseria gonorrhoeae. The upshot of the CDC recs: treat cefixime failure with the combination of IM ceftriaxone (250 mg) + oral azithromycin (2 gm). Report ceftriaxone treatment failures to CDC and “consult with an infectious diseases expert and CDC regarding re-treatment”. I guess since I’m an “infectious diseases expert” I’d better start thinking about what I’d advise (as the MMWR piece points out, “no other well-studied and effective antibiotic treatment options or combinations currently are available”).
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