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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.
- 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
- Tanja Popovic, MD, PhD
- Scientific Director
- John Iskander, MD, MPH
- Deputy Scientific Director
- Susan Laird, MSN, RN
- Communications Director
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- Presentation Slide Deck [3.1 MB, 66 pages, HTML]
- Gonorrhea Fact Sheet
- Antibiotic Resistance Gonorrhea Website
- GISP Website
- 2011 MMWR on Cephalosporin Susceptibility in GISP
- Fact sheet to accompany the July 2011 MMWR [202 KB, 3 pages, PDF] [PDF - 202 KB]
- The New England Journal of Medicine Perspectives, "The Emerging Threat of Untreatable Gonococcal Infection”
- Page last reviewed: February 28, 2018
- Page last updated: February 28, 2018
- Content source:
- Office of the Associate Director for Science
- Page maintained by: Office of the Associate Director for Communication