The Centers for Disease Control and Prevention (CDC) today announced a change in gonorrhea treatment guidelines. According to the CDC, gonorrhea treatments should now be limited to a single class of antibiotics.
In the past, both cephalosporins and fluoroquinolones were used to treat gonorrhea, but the new recommendations stress that only cephalosporins should now be used. Researchers with the CDC have found that gonorrhea is becoming more resistant to fluoroquinolone treatments.
The research was from the national Gonococcal Isolate Surveillance Project. Louisiana was one of 26 states that participated in the project. Dr. Stephanie Taylor, director of the Project for Louisiana, reported that although the number of gonorrhea cases decreased during 2006 (as a result of Hurricane Katrina), the percentage of cases that were fluoroquinolone-resistant doubled between 2005 and 2006.
State health officials with the Department of Health emphasize that with Louisiana having among the highest rates of STDs in the nation, this announcement has particular importance.
“Louisiana reports approximately 12,000 cases of gonorrhea annually,” said Sharon Howard, DHH’s assistant secretary for the Office of Public Health. “The rate for 2005 was 212 cases per 100,000 citizens, ranking us number two for gonorrhea case rates.”
Howard added that new treatment recommendations for gonorrhea are critical to preserve progress in controlling one of the nation’s most common STDs.
“There is an urgent need for new, effective medicines to treat gonorrhea. With the loss of fluoroquinolones, recommended gonorrhea treatments are now limited to a single class of antibiotics. Thus, there is a need for increased vigilance in monitoring drug resistance,” she said.
New Orleans is one of 26 sentinel surveillance sites for researching gonorrhea’s resistance to antibiotics.
The Gonococcal Isolate Surveillance Project is a collaborative effort between the Delgado Personal Health Center, the LSU Infectious Disease Laboratory, the Louisiana Office of Public Health STD Program Office and the Louisiana Office of Public Health Microbiology Laboratory.
Key Facts and Recommendations
1. Recommendations for Physicians – Physicians should screen patients who are at increased risk for gonorrhea and chlamydia. The highest reported rates of infection are among persons under 24 years of age who have multiple sex partners and engage in unprotected sexual intercourse. Patients who are infected with or exposed to gonorrhea should be treated with a cephalosporin class antibiotic.
2. Recommendations for Individuals – The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse or to be in a long-term, mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.
Any genital symptoms such as discharge or burning during urination or unusual sore or rash should be a signal to stop having sex and to see a doctor immediately. If a person has been diagnosed and treated for gonorrhea, he or she should notify all recent sex partners so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from gonorrhea and will also reduce the person's risk of becoming re-infected. The person and all of his or her sex partners must avoid sex until they have completed their treatment for gonorrhea.
3. STD/HIV Link – Individuals who are infected with STDs are at least two to five times more likely than uninfected individuals to acquire HIV if they are exposed to the virus through sexual contact. In addition, if an HIV-infected individual is also infected with another STD, that person is more likely to transmit HIV through sexual contact than other HIV-infected persons.
4. Increased Infectiousness – Studies have shown that when HIV-infected individuals are also infected with other STDs, they are more likely to have HIV in their genital secretions.
Stephanie N. Taylor, MD
Associate Professor, LSU Health Sciences Center, Section of Infectious Diseases Medical Director, Delgado Personal Health Center
Louis Trachtman, MD, MPH
Office of Public Health, STD Program