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ARTICLE

Patients Recently Treated with Azithromycin Show Increased Resistance to Treatment for Neisseria gonorrhoeae

JUL 10, 2017 | SAMAR MAHMOUD, MS
The bacterium Neisseria gonorrhoeae is the causative agent of gonorrhea, which is listed by the National Institute of Health (NIH), as the second most commonly reported infectious disease in the United States. Neisseria gonorrhoeae can infect the reproductive tract and fallopian tubes in women as well as the urethra, anus, mouth, throat, and eyes of both females and males. Untreated gonorrhea increases a patient’s risk of acquiring HIV and can lead to infertility as well as pelvic inflammatory disease. When passed from an infected mother to her child, gonorrhea can cause blindness or life-threatening complications in the child. This bacterium is particularly adept at developing new strategies to evade antibiotics, raising concerns that Neisseria gonorrhoeae may soon be resistant to all classes of currently available antibiotics.
 
Current clinical guidelines recommend the use of combination drug therapy to treat gonorrhea, consisting of the antibiotics ceftriaxone plus azithromycin. However, there have been increasing reports of azithromycin resistant strains reported. In a new study published in the journal, Clinical Infectious Diseases, principal investigator Henry JC. de Vries, MD, PhD, Professor of Skin Infections at the University of Amsterdam, and his colleagues examined the correlation between exposure to the drug azithromycin and decreased susceptibility of N. gonorrhoeae
 
The authors conducted a retrospective study consisting of patients who visited a sexually transmitted infections (STI) outpatient clinic in Amsterdam between the years 1999 and 2013. For patients to be included in the study, they had to have a positive N. gonorrhoeae culture and had to have visited the STI clinic in the 60 days before being diagnosed with gonorrhea. In terms of exposure to azithromycin, the authors divided the patients into 3 groups, those unexposed to the drug in the 60 days preceding diagnosis, those exposed between 31 to 60 days before diagnosis, and those exposed in the 30 days prior to diagnosis. The authors sought to determine the relationship between exposure to azithromycin and the minimum inhibitory concentration (MIC).


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