August 29, 2006
Citing a sharp increase in the incidence of gonorrhea in Tel Aviv, Israel, since 1999, the authors noted that nearly one-half of interviewed patients admitted contracting the infection from a sex worker. In two-thirds of cases, oral sex (fellatio) was the most probable route of acquiring the disease. In this study, the researchers assessed the prevalence of pharyngeal gonorrhea among sex workers in Tel Aviv and evaluated the efficacy of a single 2-g dose of azithromycin in eradicating infection.
The investigators obtained throat specimens for gonococcal culture from 301 female sex workers practicing in brothels. Participants answered a questionnaire covering demographic and sexual behavior information, and they took a single 2-g dose orally under supervision. Women with positive cultures were re-examined a week later for eradication of Neisseria gonorrhoeae.
The researchers isolated N gonorrhoeae from 27 women (9 percent). The median age of women with pharyngeal gonorrhea was 23 (range, 18-32 years). Eighty-five percent were born in the former Soviet Union -- mostly Russia, Moldavia and Ukraine. Eighty-eight percent of the participants reported regular condom use in vaginal sex, but only 60 percent reported always using condoms for oral sex. All isolates were susceptible to azithromycin (MIC "A high carriage rate of gonococci in the throat and a low rate of condom use in oral sex were documented among sex workers in Tel Aviv," the authors concluded. "A single 2-g dose of azithromycin was very effective in eradicating gonococci from the throat.