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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED KINGDOM: Gonorrhea Becomes More Resistant to Last-Line Antibiotics, but New Guidelines May Stop Its Spread
By Cindy del Rosario
June 12, 2013
Medical Daily (06.10.2013)

Results of a study in the United Kingdom suggested that changes in prescriptions to treat gonorrhea may have halted the spread of the resistant strain. Researchers analyzed Neisseria gonorrhea, the bacteria that cause the disease, collected from patients through Public Health England’s Gonococcal Resistance to Antimicrobials Surveillance Programme from 2007 to 2011 to determine how high a concentration of cefixime, a type of cephaslosporin, would be required to kill the bacteria. Results showed that a greater percentage of the samples needed high concentrations of the drug to fight the disease, indicating that the bacteria were becoming resistant to cefixime. In 2007, 1.5 percent of samples had become resistant; in 2010, 17.1 percent; and in 2011, 10.8 percent. Further analysis indicated that the resistant bacteria were more common in the following patients: homosexual men, individuals older than age 19 years, the HIV-positive, and persons with higher rates of partner change. Also, the bacteria that were more susceptible to cefixime treatment were found in heterosexual populations. Researchers noted that the drop in cefixime-resistant samples from 2010 to 2011 coincided with the national treatment guidelines instituted during that time. The guidelines specify gonorrhea treatment using high-dose ceftriaxone and azithromycin before the bacterial resistance reaches a certain threshold. The researchers suggest that this drop in resistance indicated that guidelines might be effective in stopping the spread of the disease. The full report, “Decreased Susceptibility to Cephalosporins among Gonococci: Data from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) in England and Wales, 2007–2011,” was published online in the journal The Lancet Infectious Diseases (2013; doi:10.1016/S1473-3099(13)70143-9).