Challenges with gonorrhea in the era of multi-drug and extensively drug resistance – are we on the right track?. Issue 6 (June 2014)

• Record Type: Journal Article
• Authors: Unemo, Magnus; Golparian, Daniel; Shafer, William M
• Is Part Of: Expert review of anti-infective therapy. Volume 12:Issue 6(2014)
• Page Start: 653
• Page End: 656
• Publication Date: 2014-06
• Subjects: Anti-infective agents -- Research -- Periodicals; 616.90461
• DOI: 10.1586/14787210.2014.906902
• Languages: English
• ISSNs: 1478-7210

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <italic>Neisseria</italic> <italic>gonorrhoeae</italic> has retained antimicrobial resistance to drugs previously recommended for first-line empiric treatment of gonorrhea, and resistance to ceftriaxone, the last option for monotherapy, is evolving. Crucial actions to combat this developing situation include implementing response plans; considering use of dual antimicrobial regimens; enhancing surveillance of gonorrhea, gonococcal antimicrobial resistance, treatment failures and antimicrobial use/misuse and improving prevention, early diagnosis, contact tracing and treatment. The ways forward also include an intensified research to identify novel antimicrobial resistance determinants and develop and evaluate appropriate use of molecular antimicrobial resistance testing, ideally point-of-care and with simultaneous detection of gonococci, to supplement culture-based methods and ideally guide tailored treatment. It is crucial with an enhanced understanding of the dynamics of the national and international emergence, transmission and evolution of antimicrobial-resistant gonococcal strains. Genome sequencing combined with epidemiological metadata will detail these issues and might also revolutionize the molecular antimicrobial resistance testing. Ultimately, novel antimicrobials are essential and some antimicrobials in development have shown potent <italic>in vitro</italic> activity against gonococci. Several of these antimicrobials deserve further attention for potential future treatment of gonorrhea.</p> </abstract>