Only one drug type now knocks out gonorrhea in U.S.

By Megan Rauscher

NEW YORK (Reuters Health) - Due to drug resistance, one class of antibiotics should no longer be used to treat gonorrhea, officials with the US Centers for Disease Control and Prevention (CDC) announced Thursday.

They no longer recommend antibiotics called fluoroquinolones -- which include ciprofloxacin, ofloxacin, and levofloxacin -- for treatment of gonorrhea because fluoroquinolone-resistant gonorrhea is now widespread in the United States.

Consequently, only one class of drugs, the cephalosporins, is still recommended and available for the treatment of gonorrhea, Dr. John M. Douglas, Jr., of the CDC declared in a news briefing.

Since 1993, fluoroquinolones have been used widely to treat gonorrhea, the CDC notes in its publication, the Morbidity and Mortality Weekly Report, where the new data and treatment recommendations appear.

Beginning in 2000, however, fluoroquinolones were no longer recommended for gonorrhea infections acquired in Asia or the Pacific Islands, including Hawaii. In 2002, this recommendation was extended to California, and in 2004, the CDC recommended that these antibiotics not be used in the US to treat gonorrhea infections in gay men.

On the basis of the most recent evidence from surveillance in 26 cities, the CDC no longer recommends the use of these drugs for the treatment of gonorrhea in any group, anywhere in the US.

"We have reached a level of fluoroquinolone resistance that threatens our ability to treat the disease across populations," Dr. Douglas said.

Gonorrhea is the second most commonly reported infectious disease in the US. In 2005, there were nearly 340,000 cases reported in the US, but CDC estimates that roughly twice that number of infections occur each year.

With only the cephalosporins left for treating gonorrhea, accelerated research for new drugs, as well as increased efforts to monitor for emerging drug resistance especially to cephalosporins, is urgently needed, according to the CDC.

SOURCE: Morbidity and Mortality Weekly Report, April 13, 2007.