Antibiotic resistance in Neisseria gonorrhoeae.
The incidence of gonorrhea is increasing in developed countries and remains high elsewhere. This untenable disease burden, the complication rate in women and newborns, and the amplification of human immunodeficiency virus transmission that accompanies gonorrhea makes control of gonococcal disease a priority. However, antibiotic resistance in Neisseria gonorrhoeae has severely compromised the successful treatment of gonorrhea. Older therapies are ineffective, whereas those that remain efficacious are unaffordable in many high-incidence settings. Penicillins, tetracyclines, and newer macrolides have limited utility, and spectinomycin (and in many parts of the world, quinolones) have been withdrawn because of resistance. Of the usually recommended treatments, only the third-generation cephalosporins, and most notably ceftriaxone, have retained their efficacy, but decreased susceptibility to these antibiotics has also appeared. A sustained decrease in gonococcal disease requires an integrated approach combining improved prevention, better diagnosis, and effective treatment. Without continued commitment and effort, gonorrhea may well become untreatable.
Tapsall
John W
JW
Department of Microbiology, World Health Organization Collaborating Centre for STD and HIV, The Prince of Wales Hospital, Sydney, Australia. j.tapsall@unsw.edu.au
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003140:Communicable Disease Control / Q000592:standards / Q000639:trends; D024881:Drug Resistance, Bacterial; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007391:International Cooperation; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects*; D011634:Public Health / Q000592:standards; D011785:Quality Assurance, Health Care / Q000592:standards; D012749:Sexually Transmitted Diseases / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission
D000900:Anti-Bacterial Agents