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Update to CDC’s Sexually Transmitted Diseases Treatment 2010 Guidelines: Oral Cephalosporins No Longer a Recommended Treatment for Gonococcal Infections


In light of recent laboratory data showing the oral antibiotic cefixime is becoming less effective, CDC has updated its STD Treatment Guidelines to no longer recommend the drug as a first-line treatment option for gonorrhea in the United States. This change leaves only one drug proven effective for treating infection, an injectable antibiotic called ceftriaxone. Over time gonorrhea has developed resistance to every antibiotic recommended, leaving the cephalosporins, which include cefixime and ceftriaxone, as the final recommended class of drugs. Because of this history and recent lab data, CDC is concerned that continued use of cefixime may prompt resistance to all cephalosporins. Limiting its use now may help preserve ceftriaxone as a treatment option for a little longer. Today, the most effective treatment for gonorrhea is dual therapy: ceftriaxone with another antibiotic. The guidelines outline alternative treatment options when ceftriaxone cannot be used. To closely monitor for resistant infections, the guidelines advise on follow-up testing using culture-based tests. Treating gonorrhea with the most effective method may help delay the emergence of cephalosporin resistance, but it will not solve the problem. CDC is calling on public and private partners to prioritize preventing gonorrhea and developing new treatment options.

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