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July/August 2011
Patient Care and Science
Gonorrhea Susceptibility to Cephalosporins May Be Declining, CDC Reports

An analysis of 10 years’ worth of gonorrhea samples from patients across the U.S. suggests that the pathogen’s susceptibility to cephalosporins may be declining, according to a July report in the Centers for Disease Control and Prevention (CDC)’s Morbidity and Mortality Weekly Report (MMWR).

The report describes trends in cephalosporin susceptibility among Neisseria gonorrhoeae isolates from male patients in 30 U.S. cities. The analysis found that minimum inhibitory concentrations (MICs) to cephalosporins are increasing, suggesting that susceptibility to cephalosporins might be declining. The prevalence of isolates with elevated MICs remains low overall, CDC said.

From 2000 to 2010, the percentage of isolates exhibiting elevated MICs rose from 0.2 percent to 1.4 percent of isolates for cefixime, and from 0.1 percent to 0.3 percent for ceftriaxone, according to the report. No treatment failures have been observed in the U.S.

“Health care providers should use ceftriaxone and azithromycin for treatment of gonorrhea, remain vigilant for gonorrhea cephalosporin treatment failures, and report treatment failures to their local or state health departments,” the CDC report said. “Local and state health departments should promote the maintenance of local gonococcal culture capacity, establish options for local gonococcal antibiotic susceptibility testing, consider enhancing surveillance for cephalosporin-resistant gonorrhea, and report gonorrhea cases with cephalosporin treatment failure to CDC.”

The full MMWR report is available online. Additional information on the topic can be found on CDC’s website.
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