Health

Advisory

RECOMMENDED CHANGES IN THE TREATMENT OF GONORRHEA

The Delaware Division of Public Health wishes to alert the Delaware medical community about an important report from the Centers for

Disease Control and Prevention.

CDC’s April 30 MMWR contains new Gonococcal Isolate

Surveillance Project (GISP) data showing increases in resistance to fluoroquinolones (including Cipro) in the treatment of gonorrhea

overall (1%), but especially concentrated among men who have sex with men (MSM) (5%).  Surveillance data from Massachusetts and New

York City shows resistant gonorrhea rates eight times higher among MSM than among heterosexual men.

Based on this new information, CDC is now recommending that fluoroquinolones no longer be used as the first-line treatment of gonorrhea

among MSM.  CDC is now recommending instead that the injectable antibiotic ceftriaxone (Rocephin) and Spectinomycin be used instead

as the primary treatment in MSM.  Another recommended drug, cefixime (Suprax), is also recommended but is currently only available

in liquid form in the United States. Specific treatment recommendations can be obtained at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5316a1.htm

Although the new recommendations only apply to MSM at this time, CDC will continue to monitor both heterosexuals and MSM and will make

changes to the treatment recommendations as necessary.

Approximately 1128 cases of gonorrhea were reported to Delaware Division of Public Health in 2003. An estimated 52 of these are MSM. In

light of this report, DPH is recommending that clinicians advise their patients about the importance of follow-up if symptoms persist,

and be prepared to evaluate such cases by culture.

For further information, contact DPH by calling 302-744-4542.