A Case of Persistent and Possibly Treatment Resistant Pharyngeal Gonorrhea

Abstract

An HIV-negative man with pharyngeal gonorrhea had a positive test-of-cure (nucleic acid amplification test) result 7 days after treatment with ceftriaxone/azithromycin. Neisseria gonorrhoeae Multi-Antigen Sequencing Type 1407 and mosaic pen A (XXXIV) gene were identified in the test-of-cure specimen, and culture was negative. Retreatment with ceftriaxone 500 mg intramuscularly plus azithromycin 2 g orally yielded a negative test-of-cure result.

Exploring and Adapting a Conceptual Model of Sexual Positioning Practices and Sexual Risk Among HIV-Negative Black Men Who Have Sex With Men

“…Future research should continue to explore the role of oral sex in the sexual positioning behaviors among BMSM because of the relationship between oral sex and STIs. Research has shown that pharyngeal gonorrhea infections in particular have been concerning for public health because they perpetuate the risk of developing multidrug-resistant bacteria (Bissessor et al, 2014; Deguchi, Yasuda, & Ito, 2012; Levy et al, 2016). Data have shown the synergistic relationship between HIV and STIs, with particular emphasis on gonorrhea (Bernstein, Marcus, Nieri, Philip, & Klausner, 2010; Craib et al, 1995; Fleming & Wasserheit, 1999).…”

Is there a role for topical antiseptics in the treatment of gonorrhoea?

“…Dual therapy with ceftriaxone and azithromycin was introduced in 2011 in the attempt to delay further resistance and this is particularly important as these two antimicrobials are the last reliable options available 2. Worryingly, the emergence of multidrug-resistant gonorrhoea is quickly becoming a reality due to treatment failures, even after dual therapy in the UK and USA 3 4. Treatment failures mostly occur in pharyngeal infection.…”