Drug-Resistant Gonorrhea on the Rise in California and Hawaii
November 25, 2002
Gonorrhea resistant to the commonly used class of drugs fluoroquinolones, which includes ciprofloxacin and levofloxacin, is on the increase in California and Hawaii, raising the concern of federal health officials. The drugs are often used to treat the STD because they are relatively inexpensive, require only a single dose and can be given orally.Adapted from:
But new data indicate that fluoroquinolone-resistant gonorrhea has reached the continental United States, making it more likely to spread through the rest of the country, according to Dr. Lori M. Newman of the CDC and colleagues. Their report, "Increases in Fluoroquinolone-Resistant Neisseria gonorrhoeae -- Hawaii and California, 2001," was published in Morbidity and Mortality Weekly Report (2002;51(46):1041-1044).
Surveillance in San Francisco, Long Beach and San Diego during 1999 and 2000 found that less than 1 percent of gonorrhea samples tested were resistant to fluoroquinolones, while nearly 6 percent of samples from Orange County showed resistance. In 2001, 2.5 percent of gonorrhea samples from these areas were resistant to fluoroquinolone, on average.
"The increases in gonococcal resistance in California were a surprise to us, but not in Hawaii, where they have been rising for several years," Newman told Reuters Health. Only a handful of isolated cases have been reported in other states, she said.
The CDC is urging doctors to be alert for possible cases of drug-resistant gonorrhea. Researchers recommend obtaining a travel history from all patients suspected to have gonorrhea and to use cephalosporins, not fluoroquinolones, for infections acquired in California and Hawaii as well as Asia.
Noting that "We don't have a lot of antibiotic choices for gonorrhea," Newman stated that "fluoroquinolones are still very important drugs for most of the country," but "when these drugs are used, state and local health departments need to monitor for gonococcal resistance so that when it does arise we can respond appropriately."
STD Screening, Testing, Case Reporting, and Clinical and Partner Notification Practices: A National Survey of U.S. Physicians