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Antibiotic-Resistant Neisseria gonorrhoeae: The Calm before Another Storm?

Hunter H. Handsfield, MD; and William L. Whittington, MPH
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Seattle-King County Department of Public Health University of Washington School of Medicine Seattle, WA 98104


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1996;125(6):507-509. doi:10.7326/0003-4819-125-6-199609150-00013
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Since the beginning of the modern chemotherapeutic era, the treatment of gonorrhea has been dogged by the shifting antimicrobial susceptibility of Neisseria gonorrhoeae. The sulfonamides, penicillins, tetracyclines, and erythromycin all fell by the wayside as strains of N. gonorrhoeae with relative or absolute resistance to antimicrobial agents evolved and spread; by 1988, approximately one third of all gonococcal isolates in the United States had one form of resistance or another [12]. This led the Centers for Disease Control and Prevention (CDC) to recommend single-dose therapy with a broad-spectrum cephalosporin (cefixime or ceftriaxone) or a fluoroquinolone (ciprofloxacin or ofloxacin) for uncomplicated gonorrhea [3]. The past decade has been a period of relative stability in the pattern of antimicrobial susceptibility of N. gonorrhoeae and recommended treatments for gonorrhea in the United States. But this may soon change.

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