title: Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014.
abstract: We describe four cases in Sweden of verified treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg; n=3) or cefotaxime (500 mg; n=1) monotherapy. All the ceftriaxone treatment failures were caused by the internationally spreading multidrug-resistant gonococcal NG-MAST genogroup 1407 clone. Increased awareness of treatment failures is crucial particularly when antimicrobial monotherapy is used. Frequent test of cure and appropriate verification/falsification of suspected treatment failures, as well as implementation of recommended dual antimicrobial therapy are imperative.
authors.affiliation: World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, orebro University Hospital, orebro, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Golparian
authors.forename: Ak
authors.initials: A
authors.lastname: Ohlsson
authors.forename: H
authors.initials: H
authors.lastname: Janson
authors.forename: P
authors.initials: P
authors.lastname: Lidbrink
authors.forename: T
authors.initials: T
authors.lastname: Richtner
authors.forename: O
authors.initials: O
authors.lastname: Ekelund
authors.forename: H
authors.initials: H
authors.lastname: Fredlund
authors.forename: M
authors.initials: M
authors.lastname: Unemo
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D024881:Drug Resistance, Bacterial; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016133:Polymerase Chain Reaction; D013548:Sweden; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone