However, to our knowledge this is the first national study on susceptibility of N. gonorrhoeae to azithromycin and
ceftriaxone in China.
Not exact matches
But while an injection of
ceftriaxone and an azithromycin pill are supposed to be used
in combination, this may not always be the case for all patients.
The results suggest that dual therapy with azithromycin and
ceftriaxone, which has been recommended by WHO and many countries to treat gonorrhea, may not prove effective
in China.
Neisseria gonorrhoeae (N. gonorrhoeae) strains resistant to azithromycin and / or with decreased susceptibility to
ceftriaxone are common
in China, according to a prevalence study published this week
in PLOS Medicine.
Yin and colleagues found high prevalence of resistance to azithromycin (RTA; 18.6 %; 95 % CI 17.4 % -19.8 %) and decreased susceptibility to
ceftriaxone (DSC; 10.8 %; 95 % CI 9.9 % -11.9 %)
in the study population.
The latest resistance data from the European Gonococcal Antimicrobial Surveillance Programme suggest stable levels of drug resistance to cefixime, and no significant increase
in resistance to another key drug (
ceftriaxone).
Patients, enrolled
in an NIH funded study, met the following criteria [17]: (1) current positive IgG Western blot using CDC surveillance criteria assessed using a single reference laboratory (University Hospital of Stony Brook); (2) treatment for Lyme disease with at least 3 weeks of intravenous
ceftriaxone or cefotaxime that was completed at least 4 months before study entry; and (3) objective evidence of memory impairment as documented by the Wechsler Memory Scale - III compared to age -, sex - and education - adjusted population norms.
Treatment with
ceftriaxone, and high or low doses of tigecycline resulted
in the same outcome: persistence of non-cultivable B. burgdorferi
in tissues of treated mice at 90 days after completion of treatment [14].
The experimental approach utilized a
ceftriaxone regimen used by multiple research groups that consistently resulted
in persistence of non-cultivable B. burgdorferi following treatment
in C3H mice
in order to determine the ultimate fate, up to 12 months, of persisting non-cultivable spirochetes.
Collectively, these studies by multiple research groups
in multiple mammalian species following treatment with an array of antimicrobial drugs, including doxycycline, ampicillin, amoxicillin,
ceftriaxone, and tigecycline, have documented a similar outcome: persistence of non-cultivable B. burgdorferi following antibiotic treatment.
High - level
ceftriaxone - resistant gonorrhea, discovered
in Japan and called H041, was first isolated from a sex worker's throat.
In lab tests, it was susceptible to spectinomycin and rifampin (unfortunately, oral gonorrhea can only be treated by an injection of
ceftriaxone).
Researchers confirmed that other gonococci strains were able to take up the
ceftriaxone - resistance gene, showing its potential to spread
in the wild population.
This cluster of drug - resistant cases was identified
in Honolulu
in April and May of this year, with five infections showing «dramatic» resistance to azithromycin, as well as reduced vulnerability to
ceftriaxone.
While azithromycin interferes with the bacteria's ability to make proteins, and
ceftriaxone causes the cell wall to fall apart, this new drug acts on a crucial protein involved
in bacterial DNA replication.
At their conference
in September, the CDC announced a cluster of gonorrhea infections that are highly resistant to azithromycin, and that fall prey only to high doses of
ceftriaxone.