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.
In lab tests, it was susceptible to spectinomycin and rifampin (unfortunately, oral gonorrhea can only be treated by an injection
of ceftriaxone).
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.
Not exact matches
However, to our knowledge this is the first national study on susceptibility
of N. gonorrhoeae to azithromycin and
ceftriaxone in China.
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).
Forty - six countries have reported gonorrhea strains with decreased susceptibility to
ceftriaxone, and 10 have reported patients for whom none
of the usual antibiotics were effective, Wi says.
Resistance to azithromycin, however, appears to be increasing and the effectiveness
of this recommended dual treatment might be under threat if resistance to third - generation cephalosporins (cefixime and
ceftriaxone) also starts to increase again.
Madrid, Spain: The antibiotic combination treatment piperacillin - tazobactam was significantly less effective than meropenem when treating potentially fatal bloodstream infections (BSI) caused by
ceftriaxone - resistant Escherichia coli and Klebsiella pneumoniae and should be avoided when treating these organisms, according to research presented at the 28th European Congress
of Clinical Microbiology and Infectious Diseases (ECCMID)[1].
The other drug,
ceftriaxone, helps clear glutamate, excessive amounts
of which can destroy neurons.
Public health alerts helped physicians recognise cases
of typhoid that were resistant to
ceftriaxone, an antibiotic reserved to treat multidrug - resistant infections.
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.
Treatment
of C3H mice with
ceftriaxone is a useful model for investigation
of post-treatment persistence
of non-cultivable B. burgdorferi.
Here, we demonstrate that MISC is feasible at an X-ray free electron laser by studying the reaction
of M. tuberculosisß - lactamase microcrystals with
ceftriaxone antibiotic solution.
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.
Lyme disease patients with heart or nervous system problems may be given a two - to four - week course
of IV antibiotics, such as
ceftriaxone or penicillin.
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.
The last line
of defense we have is a one - two punch
of a pair
of antibiotics: azithromycin and
ceftriaxone.