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 in treating gonorrhea, 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 the infection, an injectable antibiotic called ceftriaxone. Gonorrhea has eventually developed resistance to every antibiotic recommended for treatment. In 2007, widespread drug resistance prompted CDC to no longer recommend fluoroquinolones for treatment, leaving only the class of drugs known as cephalosporins (which includes cefixime and ceftriaxone). Because of this history and the 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. To closely monitor for ceftriaxone-resistant infections, the guidelines offer additional guidance on the use of follow-up testing with culture-based tests. Though the revised guidelines may help delay cephalosporin-resistant gonorrhea, this alone will not solve the problem. CDC is also calling on public and private partners to prioritize gonorrhea prevention and the development of new treatment options.