Journal Article

A Randomized Trial of Ciprofloxacin versus Cefixime for Treatment of Gonorrhea after Rapid Emergence of Gonococcal Ciprofloxacin Resistance in The Philippines

Mari Rose Aplasca de los Reyes, Virginia Pato-Mesola, Jeffrey D. Klausner, Ricardo Manalastas, Teodora Wi, Carmelita U. Tuazon, Gina Dallabetta, W. L. H. Whittington and King K. Holmes

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 9, pages 1313-1318
Published in print May 2001 | ISSN: 1058-4838
Published online May 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/319998
A Randomized Trial of Ciprofloxacin versus Cefixime for Treatment of Gonorrhea after Rapid Emergence of Gonococcal Ciprofloxacin Resistance in The Philippines

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From 1994 through 1996–1997, high-level ciprofloxacin resistance (minimum inhibitory concentration [MIC], ⩾4.0 µg/mL) increased from 9% to 49% of gonococcal isolates recovered from consecutive female sex workers in Cebu and Manila, The Philippines (P < .01). During 1996–1997, 105 female sex workers with gonorrhea were prospectively randomized to receive treatment with oral ciprofloxacin, 500 mg, or cefixime, 400 mg, and followed for test of cure. Neisseria gonorrhoeae was reisolated within 28 days after treatment from 1 (3.8%) of 26 women given cefixime versus 24 (32.3%) of 72 women given ciprofloxacin (P < .01). Treatment failure (reisolation of pretreatment auxotype/serovar) occurred in 14 (46.7%) of 30 women infected with strains with MICs of ciprofloxacin ⩾4.0 µg/mL versus 1 (3.6%) of 28 infected by strains with MICs <4.0 µg/mL (P < .01). High-level, clinically significant gonococcal resistance to ciprofloxacin has rapidly emerged in The Philippines, and spread of fluoroquinolone resistance through commercial sex poses a threat to control of gonorrhea and prevention of human immunodeficiency virus infection and the acquired immunodeficiency syndrome.

Journal Article.  2932 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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