Holiday Sex Spreads Drug-Resistant Gonorrhea in UK

Drug-resistant strains of gonorrhea are on the rise across the United Kingdom, fueled in part by people who contract the STD while on holiday, according to researchers. "There's a very strong association between having sex abroad and drug resistance," said Dr. Kevin Fenton of Britain's Health Protection Agency.

The proportion of gonorrhea strains that were resistant to the first-line antibiotic ciprofloxacin rose from 3 percent in 2001 to almost 10 percent in 2002, according to Fenton and colleagues. Their full report, "Ciprofloxacin Resistance in Neisseria Gonorrhoeae in England and Wales in 2002," appeared in the Lancet (2003;361:1867-1869).

The researchers tested more than 2,000 samples of gonorrhea bacteria, collected from 26 clinics in England and Wales, each year in 2000, 2001 and 2002. In 2002, more than 20 percent of bacteria isolated from people who had sex with a new partner while abroad were drug-resistant, compared with 8.6 percent in the rest of the infected population. "It's possible that as people are traveling more, going on short trips and having sex with new partners, they are risking bringing different strains of gonorrhea back home," Fenton said. Levels of ciprofloxacin resistance are particularly high in parts of the Far East, though a significant portion of people in the study had traveled in Western Europe.

The antibiotics ciprofloxacin, ofloxacin and ampicillin/probenecid are all recommended as first-line treatments for gonorrhea in the United Kingdom, but most clinics use ciprofloxacin. For a treatment to effectively prevent the spread of gonorrhea it needs to clear the infection in at least 95 percent of patients. Ciprofloxacin no longer meets that criteria, the researchers reported. The team recommended a review of national treatment guidelines and the use of such antibiotics as cephalosporins or spectinomycin.

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