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Div. of Media Relations
1600 Clifton Road
MS D-14
Atlanta, GA 30333
(404) 639-3286
Fax (404) 639-7394 |
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Press Release
Embargoed Until:
April 29, 2004, Noon EDT |
Contact: NCHSTP,
Office of Communications
(404) 639-8895 |
Increasing Cases of Drug-Resistant Gonorrhea
Prompt New Treatment Recommendation for
Gay and Bisexual Men
The Centers for Disease Control and Prevention (CDC) recommended today
that fluoroquinolones no longer be used as first-line treatment for
gonorrhea among men who have sex with men (MSM). The recommendation was made
after preliminary data showed that drug-resistant gonorrhea cases increased
significantly in the United States in 2003, particularly among gay and
bisexual men. Reports from Massachusetts and New York City also indicate
that rates of resistant gonorrhea in 2003 were up to eight times higher
among MSM than among heterosexual men.
A CDC study of men seen at sexually transmitted disease clinics in 23
U.S. cities that participate in the CDC’s gonococcal surveillance program
found that the proportion of gonorrhea cases resistant to fluoroquinolones
(ciprofloxacin, ofloxacin, and levofloxacin) more than doubled, from 0.4
percent in 2002 to 0.9 percent in 2003. Occurrence of fluoroquinolone-resistant
Neisseria-gonorrhoeae (QRNG) was highest among MSM, increasing nearly
three-fold from 1.8 percent in 2002 to 4.9 percent in 2003. The nearly 5
percent rate among MSM was 12 times higher than among heterosexual men (0.4
percent).
Regional data support the national findings. The Massachusetts State
Laboratory Institute reported that QRNG was identified more than six times
as often in isolates from MSM than heterosexual men in the period January
through August 2003 (11.1 and 1.8 percent, respectively). Similarly, New
York City’s Department of Health and Mental Hygiene reported that QRNG was
nearly eight times more common among MSM than heterosexual men from January
through July 2003 (12.5 and 1.6 percent, respectively).
“These national and regional data show that drug-resistant gonorrhea is a
rapidly emerging health concern, particularly for gay and bisexual men,”
said Dr. John Douglas, director of CDC’s STD prevention programs. “CDC will
continue to monitor for resistant cases in the U.S. population and update
treatment recommendations as necessary.”
The new CDC-recommended treatment options for MSM with gonorrhea include
the injectable antibiotics ceftriaxone, 125-mg IM (for anorectal,
pharyngeal, and urogenital cases) and spectinomycin, 2-g IM (for anorectal
and urogenital cases only). The antibiotic cefixime is also an option, but
is only available in liquid form in the United States.
Given the low occurrence of QRNG among heterosexual men and women, no
change in national gonorrhea treatment recommendations for this group is
warranted. Some state and local areas have changed, or may need to change,
their recommendations based on local data. CDC is working with state and
local health departments to ensure that physicians and health care providers
know about the new recommendations for drug-resistant gonorrhea in MSM and
that they receive future updates on treatment options.
# # #
CDC protects people's health and safety by preventing and
controlling diseases and injuries; enhances health decisions by providing
credible information on critical health issues; and promotes healthy living
through strong partnerships with local, national, and international
organizations.
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