Treatment and Prevention
If N. gonorrhoeae is resistant to the penicillin family of antibiotics, then ceftriaxone (a third-generation cephalosporin) is often used. Sexual partners should also be notified and treated.
Antibiotic-resistant gonorrhea has been noted by epidemiologists; beginning in the 1940s gonorrhea was treated with penicillin, but doses had to be continually increased in order to remain effective, and by the ’70s, penicillin- and tetracycline-resistant gonorrhea emerged in the Pacific Basin. These resistant strains then spread to Hawaii, California, the rest of the United States, and Europe. Fluoroquinolones were the next line of defense, but soon resistance to this antibiotic emerged as well. Since 2007, standard treatment has been third-generation cephalosporins, such as ceftriaxone, which are considered to be our “last line of defense.”
Recently, a high-level ceftriaxone-resistant strain of gonorrhea, called H041, was discovered in Japan. Lab tests found it to be resistant to high concentrations of ceftriaxone, as well as most of the other antibiotics tested. Within N. gonorrhoeae, there are genes that confer resistance to every single antibiotic used to cure gonorrhea, but thus far they do not coexist within a single gonococcus. Because of N. gonorrhoeae’s high affinity for horizontal gene transfer, however, antibiotic-resistant gonorrhea is seen as an emerging public health threat.
Patients should also be tested for other sexually transmitted infections, especially Chlamydia infections, since co-infection is frequent (up to 50% of cases). Antibacterial coverage is often included for Chlamydia because of this.
Transmission can be reduced by the usage of latex barriers, such as condoms or dental dams, during intercourse, oral and anal sex, and by limiting sexual partners.
Read more about this topic: Neisseria Gonorrhoeae
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