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Gay Outbreak of Gonorrhea Worries CDC
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Atlanta Journal-Constitution
April 30, 2004
M.A.J. McKenna
Increases in fluoroquinolone-resistant gonorrhea among gayand bisexual men have led CDC to change gonorrhea treatmentrecommendations for some patients, the agency announced Thursday.All men who are diagnosed with gonorrhea and who acknowledgehaving sex with other men - whether or not they self-identify asgay - should now receive the injectable antibiotic drugceftriaxone for treatment instead of fluoroquinolone antibioticsincluding ciprofloxacin (Cipro) and ofloxaxin.
Fluoroquinolone-resistant gonorrhea is common in Asia andEngland, and it appeared in Hawaii and California in recent years,CDC officials said. Between 2001-2003, resistant gonorrhea wasfound in a survey of 30 US cities, accounting for 4.9 percent ofcases among gay and bisexual men and 0.4 percent amongheterosexuals.
CDC believes the strain arrived from Asia via men who had sexabroad, and it then spread to other men through tight socialnetworks on the West Coast, said Dr. John Douglas, director ofCDC's STD prevention programs. The spread of any STD also impliesthe failure to practice safe sex and thus increased vulnerabilityto HIV infection, he said.
Most heterosexuals who are diagnosed with gonorrhea can stillbe treated with Cipro. However, heterosexual patients who believetheir infection is linked to one of the locations where resistantgonorrhea strains are common should receive ceftriaxone. Doctorsstill treating patients with the older drugs should also be alertto the possibility that the drugs are not working, said CDC.Because of the threat of resistant gonorrhea spreading to the restof the population - perhaps via men who have sex with both men andwomen - CDC is beginning further research on gonorrhea amongwomen.
Doctors should be conscientious about questioning patientsabout their recent travels as well as their sexual partners toknow how to treat them, said CDC.
The full report, "Increases in Fluoroquinolone-ResistantNeisseria gonorrhoeae Among Men Who Have Sex with Men - UnitedStates, 2003, and Revised Recommendations for Gonorrhea Treatment,2004," is published in Friday's Morbidity and Mortality WeeklyReport (2004;53(16):335-338).
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