New treatment expected to be
advised for gonorrhea
By DANIEL YEE The Associated Press: April 27, 2004
ATLANTA - The government is expected to recommend this week that
doctors switch to another antibiotic for treating gonorrhea because of
an alarming rise in drug-resistant cases of the sexually transmitted
disease, top experts said yesterday.
The class of antibiotics commonly used to treat gonorrhea,
including Cipro, is no longer effective against certain strains of the
bacteria, said Dr. Jeffrey Klausner, deputy health officer and director
of STD prevention for the San Francisco Department of Public Health.
In place of Cipro, which is administered as a pill, the Centers
for Disease Control and Prevention is expected to recommend
ceftriaxone, which is less convenient because it is injected, Klausner
said. Another recommended drug, cefixime, is in pill form but is no
longer made in the United States.
CDC spokeswoman Jessica Frickey said the agency plans to
announce new recommendations Thursday for treating gonorrhea, but would
not give details. Klausner and another health official who worked with
the CDC on its new guidelines disclosed them.
Cipro has been used for at least four years to fight gonorrhea.
In some areas, such as in Los Angeles County, Cipro-resistant
strains account for as many as 12 percent of all cases, said Dr. Peter
Kerndt, director of the sexually transmitted disease program for the
Los Angeles County Public Health Department.
"What's remarkable for us is how quickly it went up from 1 or 2
percent" in 2001, Kerndt said.
Cipro-resistant gonorrhea has apparently spread eastward across
the country after first appearing 15 years ago in Southeast Asia. An
increase of cases among men in Seattle, Chicago, New York and other
areas in recent months prompted the CDC to review its national
recommendations for treatment, said Dr. H. Hunter Handsfield, director
of the STD-control program for Seattle and King County.
health officials already have revised their guidelines, as resistant
cases of gonorrhea increased from 3.8 to 16.5 percent last year. About
90 percent of the cases were among gay and bisexual men.
The new recommendations
may present problems for health officials and patients. Cipro was easy
for patients to use and commonly found in doctors' offices. However,
ceftriaxone must be injected by a doctor or nurse and clinics do not
have ample supplies, Klausner said.
Cipro became widely known during the anthrax scare in 2001, when
it was given to people exposed to the lethal spores.