Dual Therapy No Longer Recommended
CDC recently updated its recommendation for the treatment of uncomplicated gonorrhea in adolescents and adults. Gonorrhea should now be treated with just one higher dose (500 mg) injection of ceftriaxone. Dual therapy is no longer the recommended approach. The new recommendations are available in 2020 Update to CDC’s Treatment for Gonococcal Infections, a special policy note published on December 17 in MMWR.
Drug-resistant gonorrhea remains an urgent public health threat, as identified in CDC’s Antibiotic Resistance Threats in the United States, 2019 (AR Threats Report). In fact, half of all gonorrhea infections are resistant to at least one antibiotic. The change from dual therapy to monotherapy was prompted by:
- Antibiotic stewardship and the need to minimize antibiotic exposure unless the benefit clearly outweighs the risk
- Further evidence and understanding of ceftriaxone’s pharmacokinetics (how drugs move in the body) and pharmacodynamics (biochemical and physiologic effects of drugs) in relation to identifying the optimal dose to treat gonorrhea
- Signs that azithromycin resistance is increasing. While CDC is not seeing treatment failures in the U.S. yet, continuing to monitor and prepare for resistance is paramount. It’s important that researchers and pharmaceutical companies jump-start research to identify or develop novel, effective treatment options.
Effective treatment—the cornerstone of U.S. gonorrhea control efforts—begins with action from state and local health departments, health care providers, community-based organizations, and other partners in the field of STDs. By implementing this new gonorrhea treatment recommendation now, along with scaling up prevention education and counseling, we can prevent this common infection with potentially severe health consequences.
#Clinicians: Effective treatment is the cornerstone of US #Gonorrhea control efforts. Follow CDC’s NEW treatment recommendations to guard against #DrugResistance and ensure that patients receive the most effective care. https://go.usa.gov/xArtw #STDcare