New Treatment Recommendations for Gonorrhea

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

In April, 2007, the U.S. Centers for Disease Control and Prevention recommended changes in the established treatment for gonorrhea infections.

Gonorrhea, the sexually transmitted disease (STD) resulting from infection with the bacteria known as Neisseria gonorrheae (also referred to as N. gonorrheae or gonococcus), affects over 339,000 persons each year in the U.S. Previously, a class of antibiotics known as the fluoroquinolones [examples are ciprofloxacin (Cirpo, Cipro XR), ofloxacin (Floxin), and levofloxacin (Levaquin)] was widely used in the treatment of gonorrheal infection. Because of increasing resistance of many tested samples of N. gonorrheae to the fluoroquinolone drugs, the CDC now recommends that only one class of antibiotics, the cephalosporins, be used to treat gonorrheal infections.

The cephalosporins include cefotaxime (Claforan), cephalexin (Keflex, Keftabs), cefaclor (Ceclor), cefoxitin (Mefoxin), ceftazidime (Ceptaz), cefixime (Suprax), and many other antibiotics. Because of increasing resistance to the fluoroquinolones, the use of cephalosporins in the treatment of gonorrhea has already been recommended by the CDC in previous years for certain groups of individuals (those who acquired their infection in Asia, the Pacific Islands, or California, as well as in men who have sex with men (MSM)).

The CDC changed the treatment recommendations for all individuals infected with gonorrhea in April 2007, based upon the results of a study known as the Gonococcal Isolate Surveillance Project (GISP), which has tested individually-isolated samples of N. gonorrheae for susceptibility to treatment by different antibiotics.

Antibiotic resistance develops in bacteria over time since bacteria are able to mutate, or change, into forms that can survive despite the administration of drugs meant to kill or weaken them. The development of antibiotic resistance can make it difficult to treat some conditions effectively with antibiotics. In addition to gonorrhea, tuberculosis, malaria, and childhood ear infections are examples of conditions that are becoming more and more difficult to treat due to antibiotic resistance. The development of antibiotic resistance is believed to occur largely due to over-use of antibiotics and the increasing use of antibiotics in both humans and animals.