Gonorrhoea treatment guidelines need urgent review, say public health officials

Michael Carter
Estimated reading time 2 minutes
This article is more than 22 years old.

Ciprofloxacin should no longer be the first choice antibiotic to treat gonorrhoea in the UK as almost 10% of cases of the sexually transmitted infection involve strains of the bacteria resistant to the drug, according to an article published in the May 30th edition of The Lancet.

The Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) has been monitoring trends in drug resistant gonorrhoea diagnosed in the UK since 2000. In 2001, a little over 3% of the 2,369 cases of gonorrhoea involved infection with ciprofloxacin resistant bacteria. However, in 2002 this increased over three-fold to 9.8%.

Regions with the highest rates of ciprofloxacin resistant gonorrhoea were Yorkshire and Humberside (18.4%), East Midlands (16.5%), the Southeast (13.7%), and the West Midlands (12.1%). In London, 7.2% of gonorrhoea was ciprofloxacin resistant. In heterosexual men, 12.2% cases of gonorrhoea were drug resistant, as were 6.5% (a three-fold increase on 2001) in heterosexual women and 8.5% (an almost four-fold increase) in gay men.

Glossary

antibiotics

Antibiotics, also known as antibacterials, are medications that destroy or slow down the growth of bacteria. They are used to treat diseases caused by bacteria.

bacteria

Single-celled micro-organisms.

strain

A variant characterised by a specific genotype.

 

Foreign travel, which had been associated with many cases of ciprofloxacin resistant gonorrhoea, was not found to be a major risk factor, suggesting that the infection with the drug-resistant bacteria was occurring in the UK. In China and Hong Kong 98% of gonorrhoea cases are now drug resistant, as are 43% of cases in Hawaii and 23% in San Francisco.

The GRASP study also found that 9.8% of gonorrhoea was resistant to penicillin, and 44.7% to tetracycline. No resistance to the antibiotic ceftriaxone was found, and only very low levels of resistance to azithromycin and spectinomycin.

Treamtent guidelines should, the investigators recommend, be amended to recommend antibiotics from the cephalosporins class (which includes ceftriaxone), or spectinomycin as first line treatment for gonorrhoea.

Further information on this website

10% of gonorrhoea in UK now drug resistant - news report April 16

Gonorrhoea factsheet

Ciprofloxacin - overview

References

Fenton KA et al. Ciprofloxacin resistance to Neisseria gonorrhoeae in England and Wales in 2002. The Lancet 361: 1867 – 1869, 2003.

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