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CDC changes recommendations for gonorrhea treatment

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WASHINGTON (CNN) -- -- The Centers for Disease Control and Prevention is recommending a change in drug therapies for gonorrhea because of widespread resistance to the antibiotics currently used to treat the disease.

According to the CDC, resistance to fluoroquinolones -- a class of antibiotics that includes ciprofloxacin, levofloxacin and ofloxacin, and the first-line treatment for gonorrhea since 1993 -- increased among heterosexuals from 0.6 percent in 2001 to 6.7 percent last year.

Among both homosexual and heterosexual men, last year's incidence of resistance was 13.3 percent, the CDC said.

The move limits gonorrhea treatment options to a single class of antibiotics called cephalosporins. Of these, only two are being recommended for use: cetriaxone, an injectable antibiotic; and cefixime, a 400 mg tablet taken orally but currently not available in the United States because the patent expired in 2002 and the drug was discontinued

According to the CDC, the Food and Drug Administration is working with a drug manufacturer to get a generic version of the drug back on the market.

The new data came from 26 U.S. cities and show even greater increases in some cities, including Philadelphia, Pennsylvania, where it rose from 1 percent in 2004 to to nearly 27 percent last year; and South Miami, Florida, where it rose from 2 percent to more than 15 percent, CDC officials told reporters in a conference call.

The data also show that resistance to fluoroquinolones is continuing to rise faster among men who have sex with men than among heterosexuals, they said, citing data published in "Morbidity and Mortality Weekly Report." That trend led the disease agency to make a similar recommendation in 2004, recommending the drugs no longer be used to treat gay men.

New treatment recommendations are critical if we are to continue to see progress in controlling gonorrhea," said Dr. John Douglas, director of the CDC's Division of STD Prevention. "We cannot afford to lose ground."

Gonorrhea is the second most commonly reported sexually transmitted disease in the country and now affects approximately 700,000 Americans each year, causing public health officials to call for accelerated research for new drugs to treat the disease and stepped up efforts to monitor resistance.

"There is also an urgent need for new, effective medicines to treat gonorrhea. We are running out of options to treat this serious disease," said Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "Increased vigilance in monitoring for resistance to all available drugs is essential."

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