title: Cefixime-resistant Neisseria gonorrhoeae in the UK: a time to reflect on practice and recommendations.
abstract: A 40-year-old man who has sex with men (MSM) with urethral gonorrhoea failed to respond to treatment with 400 mg cefixime orally. Laboratory isolation of the post-treatment strain showed a minimum inhibitory concentration of ≥0.25 mg/L, which is a level of tolerance to cefixime that has not been previously documented in the UK. This case illustrates the importance of assessing all patients after treatment for gonorrhoea so that treatment failure and antibiotic resistance can be identified. It is vital that gonorrhoea culture continues to be attempted from all infected individuals to enable accurate diagnosis and antibiotic sensitivities. We also recommend that laboratories test for cefixime sensitivity routinely, given that it is one of the most commonly prescribed treatments for gonorrhoea.
authors.affiliation: Department of Sexual Health, Great Western Hospitals NHS Foundation Trust, Swindon, UK. Sophie.Forsyth@gwh.nhs.uk
authors.forename: S
authors.initials: S
authors.lastname: Forsyth
authors.forename: P
authors.initials: P
authors.lastname: Penney
authors.forename: G
authors.initials: G
authors.lastname: Rooney
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D020682:Cefixime / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D006069:Gonorrhea / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents; D020682:Cefixime