Gentamicin in the treatment of gonorrhoea in females.

Bowie, W R; Ronald, Allan; Krywulak, W.; Cates, C. Y.; Boutros, Peter

doi:10.1136/sti.50.3.208

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…While MIC values that define resistance in documented treatment failure have not been determined for aminoglycosides, only one (2%) of our isolates had a gentamicin MIC that might be considered raised. Results of studies from the 1970s through the 1990s demonstrate a curative efficacy of 92 to 98% for gentamicin against N. gonorrhoeae (5,20,36). While several studies from the 1990s found N. gonorrhoeae sensitivity to gentamicin ranging from 94 to 100% by using an MIC breakpoint of 16 (19,(23)(24), a study of 47 men with N. gonorrhoeae-positive urethral discharge in Malawi in 2000 and 2001 found 7 (15%) had gentamicin MICs of Ͼ16 (47).…”

Section: Discussionmentioning

confidence: 99%

“…To better understand the epidemiology of resistant infection and how it may have spread within the community, we compared characteristics of men with quinolone-resistant infection to men with quinolone-susceptible infection and made similar comparisons for other antibiotics showing increased MICs. Increased MICs of cefixime (Ն0.016 g/ml), ceftriaxone (Ն0.016 g/ml), azithromycin (Ն0.25 g/ml), and gentamicin (Ն16 g/ml) were selected based on previous publications (5,12,20,36,39). Differences between categorical variables were assessed by chi-square test and with Fisher's exact test when n was Ͻ5.…”

Section: Methodsmentioning

confidence: 99%

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Emergence of Quinolone Resistance and Cephalosporin MIC Creep in Neisseria gonorrhoeae Isolates from a Cohort of Young Men in Kisumu, Kenya, 2002 to 2009

Mehta

Maclean

Ndinya‐Achola

et al. 2011

Antimicrob Agents Chemother

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We evaluated antimicrobial resistance in Neisseria gonorrhoeae isolated from men enrolled in a randomized trial of male circumcision to prevent HIV. Urethral specimens from men with discharge were cultured for N. gonorrhoeae. MICs were determined by agar dilution. Clinical and Laboratory Standards Institute (CLSI) criteria defined resistance: penicillin, tetracycline, and azithromycin MICs of >2.0 g/ml; a ciprofloxacin MIC of >1.0 g/ml; and a spectinomycin MIC of >128.0 g/ml. Susceptibility to ceftriaxone and cefixime was shown by an MIC of <0.25 g/ml. Additionally, PCR amplification identified mutations in parC and gyrA genes in selected isolates. From 2002 to 2009, 168 N. gonorrhoeae isolates were obtained from 142 men. Plasmidmediated penicillin resistance was found in 65%, plasmid-mediated tetracycline resistance in 97%, and 11% were ciprofloxacin resistant (quinolone-resistant N. gonorrhoeae [QRNG]). QRNG appeared in November 2007, increasing from 9.5% in 2007 to 50% in 2009. Resistance was not detected for spectinomycin, cefixime, ceftriaxone, or azithromycin, but MICs of cefixime (P ‫؍‬ 0.018), ceftriaxone (P < 0.001), and azithromycin (P ‫؍‬ 0.097) increased over time. In a random sample of 51 men, gentamicin MICs were as follows: 4 g/ml (n ‫؍‬ 1), 8 g/ml (n ‫؍‬ 49), and 16 g/ml (n ‫؍‬ 1). QRNG increased rapidly and alternative regimens are required for N. gonorrhoeae treatment in this area. Amid emerging multidrug-resistant N. gonorrhoeae, antimicrobial resistance surveillance is essential for effective drug choice. High levels of plasmid-mediated resistance and increasing MICs for cephalosporins suggest that selective pressure from antibiotic use is a strong driver of resistance emergence.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Emergence of Quinolone Resistance and Cephalosporin MIC Creep in Neisseria gonorrhoeae Isolates from a Cohort of Young Men in Kisumu, Kenya, 2002 to 2009

Mehta

Maclean

Ndinya‐Achola

et al. 2011

Antimicrob Agents Chemother

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“…Based on clinical efficacy, MIC data, and cost, gentamicin (240-mg single intramuscular dose) was adopted in 1993 as the treatment of choice for gonorrhea in Malawi (13,14). Singledose gentamicin has been shown to be effective in the treatment of gonococcal urethritis and cervical infection (2,7,8,15,17,19). Since early 1994, gentamicin has been widely used in the syndromic treatment of all urethral discharge but no studies of its continued efficacy have been performed.…”

mentioning

confidence: 99%

Development of an antimicrobial susceptibility surveillance system for Neisseria gonorrhoeae in Malawi: comparison of methods

et al. 1997

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Susceptibility of Neisseria gonorrhoeae to gentamicin, the primary treatment for gonorrhea in Malawi since 1993, was determined by using agar dilution MICs, E-test MICs, disc diffusion, and clinical cure rate. Agar dilution MICs were slightly higher in 1996 than in 1993 isolates, with a concomitant drop in the clinical cure rate. E-test MICs were substantially lower than agar dilution determinations, with only 77.4% within 1 log 2 concentration.

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Pelvic inflammatory disease

Faro¹

2015

Clinical Gynecology

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Gentamicin in the treatment of gonorrhoea in females.

Cited by 7 publications

References 9 publications

Emergence of Quinolone Resistance and Cephalosporin MIC Creep in Neisseria gonorrhoeae Isolates from a Cohort of Young Men in Kisumu, Kenya, 2002 to 2009

Emergence of Quinolone Resistance and Cephalosporin MIC Creep in Neisseria gonorrhoeae Isolates from a Cohort of Young Men in Kisumu, Kenya, 2002 to 2009

Development of an antimicrobial susceptibility surveillance system for Neisseria gonorrhoeae in Malawi: comparison of methods

Pelvic inflammatory disease

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