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MMWR – Morbidity and Mortality Weekly Report

1. Drug Overdose Deaths — Florida, 2003–2009

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In the United States, drug poisonings are the second leading cause of injury death after motor-vehicle crashes. This study examined drug overdose deaths in Florida from 2003 to 2009. In this seven-year period, the death rate involving prescription drugs increased by 84.2 percent. The greatest increase was observed in the oxycodone death rate (264.6 percent), followed by alprazolam (233.8 percent) and methadone (79.2 percent). Heroin rates dropped 62.2 percent, while cocaine rates rose until 2007 and then declined in 2008 and 2009. By 2009, the number of deaths involving prescription drugs in Florida was four times the number involving illicit drugs. States need to strengthen interventions aimed at reducing such overdoses and implement surveillance systems that are able to track patterns of drug use and the impact of prevention measures in a timely way.

2. Cephalosporin Susceptibility Among Neisseria gonorrhoeae Isolates — United States, January 2000–June 2010

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Data suggest the declining susceptibility to cephalosporins—the only remaining class of antibiotics available to treat gonorrhea. If left untreated, gonorrhea can cause infertility in women and increase a person's risk for acquiring HIV. Over time, the bacteria have developed resistance to several antibiotics. Currently, CDC recommends a dual therapy of cephalosporins with either azithromycin or doxycycline. The emergence of resistance to cephalosporins would substantially limit treatment options. For this article, researchers analyzed 10 years' worth of gonorrhea samples, or isolates, from male patients in 30 U.S. cities collected through CDC's Gonococcal Isolate Surveillance Project. The analysis showed an increase in the proportion of isolates with elevated minimum inhibitory concentrations (MICs), the lowest concentration of antibiotics needed to stop the bacteria's growth. Increases in MICs suggest declining antibiotic susceptibility. From 2000-2010, the percentage of isolates exhibiting elevated MICs rose from 0.2 percent-1.4 percent of isolates for cefixime (an oral cephalosporin) and from 0.1 percent-0.3 percent for ceftriaxone (an injectable cephalosporin). No treatment failures have been observed in the U.S. Authors call on public and private partners to prioritize treatment development and increase gonorrhea surveillance capacity so that emerging patterns of resistance can be recognized as they occur.

3. Update to CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: Revised Recommendations for the Use of Contraceptive Methods During the Postpartum Period

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CDC is issuing updated recommendations for the use of combined hormonal contraceptives among postpartum women. Postpartum women should not use combined hormonal contraceptives during the first 21 days after delivery because of the high risk for venous thromboembolism (VTE). During 21–42 days postpartum, women without risk factors for VTE generally can initiate combined hormonal contraceptives, but women with risk factors for VTE generally should not use these methods. After 42 days postpartum, no restrictions based on postpartum status apply. Recommendations for other contraceptives, including progestin-only contraceptives and intrauterine devices, remain unchanged; these methods are safe for postpartum women, including women who are breastfeeding, and can be initiated immediately postpartum.

 

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