Background Antimicrobial resistance in Neisseria gonorrhoeae restricts effective treatment options. Recent UK treatment guidelines recommend ceftriaxone as first line treatment. If ceftriaxone becomes unsuitable for treating gonorrhoea there are no suitable available alternatives. The potential for using past therapeutic agents for gonorrhoea treatment should be assessed.
Aim(s)/Objective(s) Identify risk factors associated with antimicrobial resistance to penicillin, tetracycline and ciprofloxacin.
Methods Data from the Gonococcal Resistance to Antimicrobials Surveillance Programme were analysed for trends in antimicrobial resistance across sub-groups of the Gonococcal Resistance to Antimicrobials Surveillance Programme population. Using 2010 data patient variables associated with penicillin, tetracycline and ciprofloxacin resistance were identified using univariate and multivariable analyses of ORS.
Results Rates of penicillin, tetracycline and ciprofloxacin resistance have increased across all regions in England and Wales in recent years, with very high levels found in white MSM. Lower rates of resistance, with <15% prevalence, indicating a susceptible population, are found in women (penicillin 6.4%, ciprofloxacin 12.8%), black ethnicity (penicillin 6.1%, ciprofloxacin 13.4%), and in some cases heterosexual men (penicillin 13.2%) and those aged under 24 (penicillin 12.6%). Univariate and multivariable analysis identified patient variables, including sexual orientation, ethnicity and age as strongly associated with penicillin, tetracycline and ciprofloxacin resistance.
Conclusions By using sub-group population prevalence data on resistance, as well as information about patient variables strongly associated with resistance, it may be possible in some cases to adapt treatment regimens to make use of previously recommended antimicrobials and preserve the use of ceftriaxone for high-risk groups.