Friday, August 19, 2016

Antimicrobial-resistant Gonorrhea

Gonorrhea is the second most commonly reported notifiable disease in the United States. National concerns about increasing rates of gonorrhea and increasing antimicrobial resistant strains of N. gonorrhoeae are prompting increased efforts to ensure adherence to the revised 2015 Sexually Transmitted Disease Treatment Guidelines.
U.S. CDC now recommends treating gonorrhea with ceftriaxone 250 mg as a single intramuscular dose and azithromycin 1 g orally.
Clinicians need to use dual therapy and stay up to date with treatment recommendations: 
  • Data show that resistance decreases when the correct dual therapy is used.
  • Using azithromycin as a monotherapy to treat gonorrhea might promote the emergence of azithromycin resistance.
  • Patients with cephalosporin allergies should be treated with azithromycin 2 g plus either gentamicin or gemifloxacin.

There has been a steady increase in the number of reported gonorrhea cases in Maine. As of June 30, 2016, 251 cases of gonorrhea have been reported to the Maine CDC. The five-year median for this time period is 116 cases. The increase in gonorrhea in Maine mirrors a national trend reported by U.S. CDC. 

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