The Management of Gonorrhea in the Era of Emerging Antimicrobial Resistance: What Primary Care Clinicians Should Know

Med Clin North Am. 2024 Mar;108(2):279-296. doi: 10.1016/j.mcna.2023.08.015. Epub 2023 Sep 14.

Abstract

Gonorrhea rates continue to rise in the United States and Neisseria gonorrhoeae's propensity to develop resistance to all therapies used for treatment has complicated the management of gonorrhea. Ceftriaxone is the only remaining highly effective recommended regimen for gonococcal treatment and few new anti-gonococcal antimicrobials are being developed. The 2021 CDC STI Treatment Guidelines increased the dose of ceftriaxone to 500 mg (1 g if ≥ 150 kg) for uncomplicated infections. It is recommended that all clinicians should be aware of antimicrobial resistant gonorrhea and be able to appropriately manage any suspected gonorrhea treatment failure case.

Keywords: Antimicrobial resistance; Gonorrhea; Neisseria gonorrhoeae; Sexually transmitted infections.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents* / therapeutic use
  • Ceftriaxone / pharmacology
  • Ceftriaxone / therapeutic use
  • Drug Resistance, Bacterial
  • Gonorrhea* / drug therapy
  • Gonorrhea* / epidemiology
  • Humans
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae
  • Primary Health Care
  • United States

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone
  • Anti-Infective Agents