title: Verified clinical failure with cefotaxime 1g for treatment of gonorrhoea in the Netherlands: a case report.
abstract: We describe the first case of treatment failure of gonorrhoea with a third generation cephalosporin, cefotaxime 1g intramuscularly, in the Netherlands. The case was from a high-frequency transmitting population (men having sex with men) and was caused by the internationally spreading multidrug-resistant gonococcal NG-MAST ST1407 clone. The patient was clinically cured after treatment with ceftriaxone 500 mg intramuscularly and this is the only third generation cephalosporin that should be used for first-line empiric treatment of gonorrhoea. Increased awareness of failures with third generation cephalosporins, enhanced monitoring and appropriate verification of treatment failures including more frequent test-of-cures, and strict adherence to regularly updated treatment guidelines are essential globally.
authors.affiliation: Public Health Laboratory, Cluster of Infectious Diseases, Amsterdam Health Service, Amsterdam, The Netherlands Department of Microbiology, Onze Lieve Vrouwe Gasthuis General Hospital, Amsterdam, The Netherlands.
authors.forename: Alje P
authors.initials: AP
authors.lastname: van Dam
authors.affiliation: Department of Microbiology, Onze Lieve Vrouwe Gasthuis General Hospital, Amsterdam, The Netherlands.
authors.forename: Marc L
authors.initials: ML
authors.lastname: van Ogtrop
authors.affiliation: Department of Laboratory Medicine, Clinical Microbiology, WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University Hospital, Örebro, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Golparian
authors.affiliation: Integral Physician Practice West, Amsterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Mehrtens
authors.affiliation: STI Outpatient Department, Cluster of Infectious Diseases, Amsterdam Health Service, Amsterdam, The Netherlands Centre for Infections and immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Henry J C
authors.initials: HJ
authors.lastname: de Vries
authors.affiliation: Department of Laboratory Medicine, Clinical Microbiology, WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University Hospital, Örebro, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Unemo
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002439:Cefotaxime / Q000008:administration & dosage*; D002443:Ceftriaxone / Q000008:administration & dosage*; D024901:Drug Resistance, Multiple, Bacterial; D006069:Gonorrhea / Q000188:drug therapy*; D018451:Homosexuality, Male; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects; D009426:Netherlands; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D002439:Cefotaxime
keywords: ANTIBIOTIC RESISTANCE; GAY MEN; GONORRHOEA; NEISSERIA GONORRHOEA; URETHRITIS