Gonorrhea infections that are resistant to fluoroquinolones have become so widespread that the CDC recommends clinicians stop using this class of antibiotics and switch to ceftriaxone (Rocephin), an injectable cephalosporin.
Between 2001 and 2006, the proportion of gonorrhea cases in the United States resistant to fluoroquinolones jumped from <1% to 13.3%, the CDC reports. In some cities in Hawaii, California, and Pennsylvania, the rate is much higher.
Gonorrhea, the second most common sexually transmitted infection after chlamydia, has not yet shown resistance to the cephalosporins. Over the years, the Neisseria gonorrhoeae organism has developed resistance to several antibiotic groups, starting with sulfa, then penicillin and the tetracyclines before the fluoroquinolones. The latter were recommended as first-line treatments in 1993.
For genital and anal gonorrhea, oral cefixime (Suprax) can be substituted for a cephalosporin, but there are no recommended oral alternatives for pharyngeal infections, the CDC says. The agency’s complete updated advisory can be viewed at www.cdc.gov/STD/treatment/2006/updated-regimens.htm (accessed April 9, 2007).