In response to a recent increase in drug resistant gonorrhea, the New York Department of Health and Mental Hygiene (DOHMH) is issuing a health alert to New York City medical providers announcing alternative treatment recommendations for individuals infected with gonorrhea. The alert is being sent out following a U.S. Centers for Disease Control and Prevention (CDC) announcement about similar trends in Massachusetts, California and the Pacific Islands including Hawaii as well as other parts of the country.
In the first 7 months of 2003, there were 22 fluoroquinolone resistant gonorrhea infections (QRNG) diagnosed in City STD clinics, an increase from eight infections in 2002 and three in 2001. Among patients who reported sexual activity, QRNG was significantly more common among gay and bisexual men (12.5%) than among other men (1.6%) and among women (2.4%).
Gonorrhea is usually treatable with a single dose of antibiotics. Today, CDC announced that medical providers should no longer use fluoroquinolones – the family of antibiotics that includes ciprofloxacin – as first-line treatment for gonorrhea in gay and bisexual men due to concerns that it is no longer effective in treating this population. While CDC still recommends its use for gonorrhea in women and other men, the New York City Health Department is recommending that providers avoid using them as the primary treatment for all cases of gonorrhea, irrespective of sexual history or orientation because patients often do not disclose this information to doctors. The most effective alternative treatment currently available is a single injection of antibiotics, which DOHMH has offered in its clinics since the 1980s.
DOHMH Commissioner Thomas R. Frieden, MD, MPH said, “While the number of drug resistant cases noted in our own clinics is low, we expect this is a larger trend in the City. Drug resistant strains can spread if not appropriately treated. Gonorrhea makes it easier to get or spread HIV and can cause life-threatening infections and infertility. This is yet another reminder about the importance of safer sex behaviors: Reduce risky sex, use condoms every time; know your HIV status and share that information with partners. It can save your life and the lives of those you love.”