Cipro-resistant gonorrhea on the rise

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In Hawaii, the proportion of cases of gonorrhea that are resistant to treatment with the antibiotic Cipro increased nearly sevenfold between 1997 and 2000, new findings show.

So-called fluoroquinolones like Cipro have been first-line treatment for gonorrhea infections since 1993, according to an article in the medical journal Sexually Transmitted Diseases, but fluoroquinolone-resistant infections were first identified in Hawaii as early as 1991.

An increase in such cases in 1999 prompted Dr. Christopher J. Iverson and colleagues from the Centers for Disease Control and Prevention, Atlanta, and the Hawaii Department of Health, Honolulu, to look into the situation.

They found that after declining steadily during the early 1990s, the overall number of gonorrhea cases reported to the Hawaii STD Program remained constant at approximately 500 cases per year from 1996 to 2000.

The percentage of infections that were resistant to Cipro increased from less than 1.5 percent in 1996 to 6.3 percent in 1998 and 10.4 percent by 2000, the investigators report.

Most of the Cipro-resistant infections were also resistant to penicillin, and 28 percent were also resistant to tetracycline. Nevertheless, all were susceptible to several other antibiotics.

Cipro-resistant cases were more common among patients who had recently traveled in Asia or had a sex partner who had done so.

Based on these findings, Iverson’s team concludes that fluoroquinolones “are no longer recommended treatment for gonorrhea infections acquired in Hawaii, Asia, or the Pacific Islands.”

SOURCE: Sexually Transmitted Diseases, December 2004. 

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