Trends in Neisseria gonorrhoeae Susceptibility to Cephalosporins in the United States, 2006-2014

Gonorrhea is a common sexually transmitted disease that, if untreated, can cause reproductive health complications. Treatments for gonorrhea have been repeatedly jeopardized by antimicrobial resistance. To ensure effective treatment, the US Centers for Disease Control and Prevention (CDC) periodically updates guidelines based on resistance trends. Following declining cephalosporin susceptibility in several countries, the CDC updated its treatment recommendation in 2010 from single-dose cephalosporin (injectable ceftriaxone or oral cefixime) to intensified combination therapy with either ceftriaxone (at a higher dose than previously recommended) or cefixime plus a second antimicrobial.¹

The CDC updated the guidelines again in 2012 to recommend ceftriaxone-based combination therapy as the single recommended therapy.¹ We describe recent gonococcal cephalosporin susceptibility trends, emphasizing changes following publication of these guidelines.