Antimicrobial resistance in N. gonorrhoeae occurs as plasmid-mediated resistance to penicillin and tetracycline, and chromosomally mediated resistance to penicillins, tetracyclines, spectinomycin, and fluoroquinolones.

Antimicrobial resistance in N. gonorrhoeae remains an important challenge to controlling gonorrhea; gonococcal strains may be resistant to penicillins, tetracyclines, spectinomycin, and fluoroquinolones. Resistance to CDC-recommended doses of ciprofloxacin and ofloxacin exceeds 40% in some Asian countries. Fluoroquinolone-resistant strains of N. gonorrhoeae have also been reported in the United States and Canada. The proportion of gonococcal isolates in Hawaii that are fluoroquinolone-resistant currently exceeds 10% and increasing numbers of resistant strains have been identified in the continental United States.   ...more...

Facts       

• Antimicrobial Resistance in Neisseria gonorrheae

Surveillance

• Gonococcal Isolate Surveillance Project (GISP)
  • Annual Reports
• Non-GISP Susceptibility Reporting

Treatment Guidelines & Health Alerts

• CDC
  • Availability of Cefixime 400 mg Tablets — United States, April 2008, MMWR April 25, 2008
    • Dear Colleague Letter (9 April 2008)
  • Updated recommended treatment regimens for gonococcal infections and associated conditions - United States, April 2007  (12 April 2007)
    • Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2006: Fluoroquinolones No Longer Recommended for Treatment of Gonococcal Infections - MMWR April 13, 2007
    • Dear Colleague Letter
  • 2006 Treatment Guidelines
    • Diseases Characterized by Urethritis and Cervicitis
      • Gonococcal Infection
      • Quinolone-Resistant N. gonorrhoeae (QRNG)
  • Notice to Readers: Discontinuation of Spectinomycin - MMWR April 7, 2006
• State and Local
  • State and Local Health Alerts
  • Recommendations for Local Susceptibility Testing

Laboratory Information

• Culture Handling Procedure
• Instructions for Submitting Specimens to CDC Gonorrhea Laboratory for Confirmation Testing and/or Testing of Clinical Treatment Failures
• Testing
  • Disk Diffusion
    • B88 document- Neisseria gonorrhoeae reference strains for antimicrobial susceptibility testing 
  • Agar Dilution
• Interpretive Criteria
• Gonorrhea Laboratory Information - Definitions, testing, identification, characteristics, strain typing and resources.

International

• Treatment
• Surveillance
• World Health Organization (WHO)

Resources and References

• Resources
• References

Archive

• Oral Alternatives to Cefixime for the Treatment of Uncomplicated Neisseria gonorrhoeae Urogenital Infections - Updated 30 April 2004
• Notice to Readers: Discontinuation of Cefixime Tablets 22 November 2002
• 2002 Screening Tests to Detect Chlamydia trachomatis and Neisseria gonorrhoeae Infections 18 October 2002
• Notice to Readers: Update on Spectinomycin Availability in the United States - MMWR. 3 August 2001