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The Growing Threat of Multidrug-Resistant Gonorrhea

Presented on .

This session of Grand Rounds explored the development of antibiotic resistance in Neisseria gonorrhoeae as a growing public health concern because the United States gonorrhea control strategy relies on effective antibiotic therapy. Since antibiotics were first used for treatment of gonorrhea, N. gonorrhoeae has progressively developed resistance to the antibiotic drugs prescribed to treat it: sulfonilamides, penicillin, tetracycline, and ciprofloxacin. Currently, CDC STD treatment guidelines recommend dual therapy with a cephalosporin antibiotic (ceftriaxone is preferred) and either azithromycin or doxycycline to treat all uncomplicated gonococcal infections among adults and adolescents in the United States.

Given the ability of N. gonorrhoeae to develop antibiotic resistance, it is critical to continuously monitor gonococcal antibiotic resistance and encourage research and development of new treatment regimens for gonorrhea.

A major challenge to monitoring emerging antimicrobial resistance of N. gonorrhoeae is the substantial decline in capability of laboratories to perform essential gonorrhea culture techniques required for antibiotic susceptibility testing. This decline results from an increased use of newer non-culture-based laboratory technology, such as a diagnostic test called the Nucleic Acid Amplification Test (NAAT). Currently, there is no reliable technology that allows for antibiotic susceptibility testing from non-culture specimens. Increased laboratory culture capacity is needed.

Presented By
Edward Hook, III, MD
Professor of Medicine and Epidemiology
University of Alabama School of Medicine
William Shafer, PhD
Professor of Microbiology and Immunology
Emory University School of Medicine
Carolyn Deal, PhD
Chief, Sexually Transmitted Diseases Branch
National Institute of Allergy and Infectious Diseases

National Institutes of Health
Robert D. Kirkcaldy, MD, MPH
Medical Officer
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
Facilitated By
Tanja Popovic, MD, PhD
Scientific Director
John Iskander, MD, MPH
Deputy Scientific Director
Susan Laird, MSN, RN
Communications Director
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Page last reviewed: February 28, 2018
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