John Bartlett, MD

Disclosures

July 23, 2003

In This Article

Cipro-Resistant Gonococci in England

Ross JD, Maw R; Bacterial Special Interest Group, and the British Clinical Co-operative Group of the MSSVD. How is gonorrhoea treated in genitourinary medicine clinics in the UK? Int J STD AIDS. 2002;13:499-500. Abstract and Fenton KA, Ison C, Johnson AP, et al. Ciprofloxacin resistance in Neisseria gonorrhoeae in England and Wales in 2002. Lancet. 2003;361:1867-1869. Abstract These are reports from the Gonococcal Resistance to Antimicrobials Surveillance Program (GRASP), which consists of 24 laboratories in the United Kingdom (UK) that perform sensitivity tests on clinical isolates of Neisseria gonorrhoeae. The report notes that the UK national guidelines for treating gonorrhea include ciprofloxacin, ofloxacin, and ampicillin/probenecid as first-line agents; about 74% of clinics use ciprofloxacin as the first-line treatment. Sequential analysis of sensitivity tests showed resistance to ciprofloxacin was 2.1% in 2000, 3.1% in 2001, and 9.8% in 2002. These results, as well as sensitivity test results for other antibiotics, are summarized in Table 21 .

The authors conclude that "... a general principle with gonorrhea is that the chosen treatment regimen should eliminate infection in at least 95% of patients, and ciprofloxacin no longer meets this criterion."

Comment: Resistance by N gonorrhoeae to fluoroquinolones is increasing substantially, but is quite regional. In the United States, surveillance reports in 2001 indicated only 0.7% of strains were fluoroquinolone resistant, but this represents a raise from previous years, and 75% of the resistant strains came from Hawaii or San Francisco.[48]

New antimicrobial agents approved by the U.S. Food and Drug Administration in 2001 and new indications for previously approved agents. Antimicrob Agents Chemother. 2002;46:1160. Abstract As reported in this article and shown in Table 22 , the following are new antimicrobial agents and new formulations approved by the FDA in 2001:

New antimicrobial agents approved by the U.S. Food and Drug Administration in 2002 and new indications for previously approved agents. Antimicrob Agents Chemother. 2003;47:2060. Abstract This article provides a list of new drugs and new formulations for 2002 ( Table 23 ).

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