Management of Gonorrhea in Adolescents and Adults in the United States

• Type of Material: Article
• Authors: Sarah Workowski, Emory University; Sarah Kidd, Emory University
• Language: English
• Date: 2015-12-15
• Publisher: Oxford University Press (OUP): Policy B - Oxford Open Option C
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
• Final Published Version (URL): http://dx.doi.org/10.1093/cid/civ731
• Title of Journal or Parent Work: Clinical Infectious Diseases
• ISSN: 1058-4838
• Volume: 61
• Issue: suppl 8
• Start Page: S785
• End Page: S801
• Grant/Funding Information: This article appears as part of the supplement “Evidence Papers for the CDC Sexually Transmitted Diseases Treatment Guidelines,” sponsored by the Centers for Disease Control and Prevention.
• Keywords: Immunology; RESISTANT NEISSERIA-GONORRHOEAE; drug therapy; GONOCOCCAL INFECTIONS; SEXUALLY-TRANSMITTED INFECTIONS; Neisseria gonorrhoeae; Microbiology; Infectious Diseases; IN-VITRO ACTIVITY; HIGH-LEVEL RESISTANCE; UNCOMPLICATED GONORRHEA; gonorrhea; SINGLE-DOSE AZITHROMYCIN; ACID AMPLIFICATION TESTS; PHARYNGEAL GONORRHEA; Life Sciences & Biomedicine; Science & Technology; TREATMENT FAILURE
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Gonorrhea is the second most commonly reported notifiable disease in the United States and is associated with serious health sequelae, including pelvic inflammatory disease, infertility, and ectopic pregnancy. Treatment for gonorrhea has been complicated by antimicrobial resistance. Neisseria gonorrhoeae has developed resistance to each of the antimicrobials that were previously recommended as first-line treatment regimens, and current treatment options are severely limited. This article summarizes the key questions and data that were discussed at the Sexually Transmitted Diseases (STD) Treatment Guidelines Expert Consultation meeting in April 2013, and the rationale for the 2015 Centers for Disease Control and Prevention STD treatment guidelines for gonococcal infections in adolescents and adults. Key issues addressed include whether to change the dosage of ceftriaxone and azithromycin used in the recommended dual treatment regimen, whether to continue to list dual treatment with cefixime and azithromycin as an alternative treatment regimen, and management of gonococcal infections in persons with severe cephalosporin allergy or suspected treatment failure.