Strains resistant to fluoroquinolones from Neisseria gonorrhoeae
Antibiotics of the fluoroquinolone class, such as ciproflocacin, levofloxacin and ofloxacin, were previously considered the drugs of choice and have been widely used in the treatment of gonorrhea. However, in a preliminary report released in April 2004, specialists from the Centers for Disease Control and Prevention (CDC, USA) announced that fluoroquinolones should no longer be used as the treatment of choice for men who have had sex with men (MGC). , as indicated high frequency of isolation of strains resistant to fluoroquinolones of Neisseria gonorrhoeae (resistant to fluoroquinolones N.gonorrhoeae, FRNG) in patients of this group.
The detection rate of FRNG rose to 4.1% in 2003 compared to 2.2% in 2002 and 0.7% in 2001, and this indicator is 10 times higher among men who have had homosexual contact. According to the Massachusetts State Laboratory, in 2003, the incidence of FRNG in MGC was 11.1% compared to 1.8% in heterosexual men. Similar data was provided by the New York Department of Health (12.5% and 1.6%, respectively). Overall, in the United States, 15% of N.gonorrhoeae isolates isolated from MGC were resistant to fluoroquinolones, compared to 1.5% of heterosexual men.
The increased resistance of N.gonorrhoeae to fluoroquinolones has led to a review of existing recommendations for the treatment of gonorrhea. According to new CDC recommendations, treatment for men who have had homosexual contact, or if they are suspected of being infected with FRNG, should be performed using one of 2 injectable antibiotics - ceftriaxone or spectinomycyte ( Trobicin). Administration of 125 mg ceftriaxone intramuscularly with anorectal, pharyngeal and urogenital gonorrhea and 2 g spectinomycin intramuscularly with anorectal and urogenital gonorrhea is recommended. Another medicine to treat gonorrhea in these patients is cefixime (Suprax).