Notice Of Change In Treatment Of Gonorrhea Issued

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Gonorrhea Treatment

The Florida Department of Health is advising Florida practitioners to discontinue use of fluoroquinolones for the treatment of gonorrhea.

The decision is based on recent data analysis from the Centers for Disease Control and Prevention's (CDC) Gonococcal Isolate Surveillance Project (GISP), a sentinel surveillance system based in 28 U.S. cities, including Miami. The GISP system monitors trends in antimicrobial susceptibilities of strains of Neisseria gonorrhoeae, the bacteria that causes gonorrhea infection. In the first half of 2006, the proportion of gonorrhea cases that were fluoroquinolone-resistant increased to 6.7 percent nationally among heterosexual men, an 11-fold increase from 0.6 percent in 2001.

Between 2001 and 2005, the Miami-Dade GISP site reported 43 fluoroquinolone-resistant cases that accounted for 5.3 percent of specimens tested. In the first half of 2006 alone, the number jumped to 31, or 14.6 percent of specimens tested. This level of resistance is well above the 5 percent antibiotic resistance threshold that the CDC uses to change its treatment guidelines.

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Now, only one class of drugs, the cephalosporins, are recommended and available for the treatment of gonorrhea. Within this class, CDC recommends ceftriaxone, available only as an injection, as the preferred treatment for all types of gonorrhea infection.

"The Department of Health has ordered an ample supply of ceftriaxone for treating county health department clients diagnosed with gonorrhea," Karla Schmitt, PhD, MPH, ARNP, Chief, Bureau of STD Prevention and Control said. "This is the fourth class of drugs to which the Neisseria gonorrhoeae has successfully developed resistance."

Gonorrhea remains the second most commonly reported sexually transmitted infection in Florida and across the nation.

DOH will expand surveillance activities in other areas of the state and disseminate health alerts to Florida practitioners as needed.

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