title: Gonorrhea treatment practices in the STD Surveillance Network, 2010-2012.
abstract: BACKGROUND
  Replacing oral treatments with ceftriaxone is a central component of public health efforts to slow the emergence of cephalosporin-resistant Neisseria gonorrhoeae in the United States; US gonorrhea treatment guidelines were revised accordingly in 2010. However, current US gonorrhea treatment practices have not been well characterized.
  
  
  METHODS
  Six city and state health departments in Cycle II of the STD Surveillance Network (SSuN) contributed data on all gonorrhea cases reported in 101 counties and independent cities. Treatment data were obtained through local public health surveillance and interviews with a random sample of patients. Cases were weighted to adjust for site-specific sample fractions and for differential nonresponse by age, sex, and provider type.
  
  
  RESULTS
  From 2010 to 2012, 135,984 gonorrhea cases were reported in participating areas, 15,246 (11.2%) of which were randomly sampled. Of these, 7,851 (51.5%) patients were interviewed. Among patients with complete treatment data, 76.8% received ceftriaxone, 16.4% received an oral cephalosporin, and 6.9% did not receive a cephalosporin; 51.9% of persons were treated with a regimen containing ceftriaxone and either doxycycline or azithromycin. Ceftriaxone treatment increased significantly by year (64.1% of patients in 2010, 79.3% in 2011, 85.4% in 2012; P = 0.0001). Ceftriaxone use varied widely by STD Surveillance Network site (from 44.6% to 95.1% in 2012).
  
  
  CONCLUSIONS
  Most persons diagnosed as having gonorrhea between 2010 and 2012 in the United States received ceftriaxone, and its use has increased since the release of the 2010 Centers for Disease Control and Prevention STD Treatment Guidelines.
authors.affiliation: From the *Public Health-Seattle & King County, Seattle, WA; †University of Washington Center for AIDS and STD, Seattle, WA; ‡US Centers for Disease Control and Prevention, Atlanta, GA; §Department of Public Health, San Francisco, CA; ¶Colorado Department of Public Health and Environment, Denver, CO; ∥Baltimore City Health Department, Baltimore, MD; **Johns Hopkins University School of Medicine, Baltimore, MD; ††California Department of Public Health, Richmond, CA; and ‡‡Chicago Department of Public Health, Chicago, IL.
authors.forename: Roxanne P
authors.initials: RP
authors.lastname: Kerani
authors.forename: Mark R
authors.initials: MR
authors.lastname: Stenger
authors.forename: Hillard
authors.initials: H
authors.lastname: Weinstock
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Bernstein
authors.forename: Mary
authors.initials: M
authors.lastname: Reed
authors.forename: Christina
authors.initials: C
authors.lastname: Schumacher
authors.forename: Michael C
authors.initials: MC
authors.lastname: Samuel
authors.forename: Margaret
authors.initials: M
authors.lastname: Eaglin
authors.forename: Matthew
authors.initials: M
authors.lastname: Golden
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use*; D002487:Centers for Disease Control and Prevention, U.S.; D018550:Cephalosporin Resistance / Q000187:drug effects; D002511:Cephalosporins / Q000627:therapeutic use; D002985:Clinical Protocols; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology*; D019983:Guideline Adherence / Q000639:trends*; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000187:drug effects; D011159:Population Surveillance; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002443:Ceftriaxone; D017963:Azithromycin; D004318:Doxycycline