CDC recommends dual therapy to combat gonorrhea resistance

The Centers for Disease Control and Prevention (CDC) is concerned about the increasing potential in gonorrhea patients for resistance to cephalosporin.

In its July 8 Morbidity and Mortality Weekly Report (MMWR), the CDC summarized findings from the Gonococcal Isolate Surveillance Project (GISP). GISP found that, between 2000 and 2010, isolates with elevated minimum inhibitory concentrations to cephalosporins increased from 0.2% in 2000 to 1.4% in 2010 for cefixime and from 0.1% percent in 2000 to 0.3% in 2010 for ceftriaxone.

“Although cephalosporins remain an effective treatment for gonococcal infections, healthcare providers should be vigilant for treatment failure and are requested to report its occurrence to state and local health departments,” said the MMWR article.

The CDC now recommends dual therapy for gonorrhea with ceftriaxone 250 mg plus either azithromycin or doxycycline.

Effective alternative antibiotics and antibiotic combinations to treat gonorrhea are needed urgently, according to the CDC. “Actions undertaken now could delay the spread of cephalosporin-resistant strains and mitigate the public health consequences,” the report stated.

In addition, state and local public health departments should promote maintenance of laboratory capability to culture Neisseria gonorrhoeae to allow testing of isolates for cephalosporin resistance, the report said.