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Recommended antimicrobial treatment of uncomplicated gonorrhoea in 2009 in 11 East European countries: implementation of a Neisseria gonorrhoeae antimicrobial susceptibility programme in this region is crucial
  1. M Unemo1,
  2. E Shipitsyna2,
  3. M Domeika3 on behalf of the Eastern European Sexual and Reproductive Health (EE SRH) Network Antimicrobial Resistance Group
  1. 1National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden
  2. 2Laboratory of Microbiology, the DO Ott Research Institute of Obstetrics and Gynaecology, St Petersburg, Russia
  3. 3Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  1. Correspondence to Dr Magnus Unemo, National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro SE-701 85, Sweden; magnus.unemo{at}orebroll.se

Abstract

Background Antimicrobial resistance (AMR) in Neisseria gonorrhoeae (gonococcus) is a major problem worldwide. Quality-assured and quality-controlled AMR surveillance data on gonococci globally are crucial for public health purposes. In East European countries, knowledge regarding gonococcal AMR and its prevalence is limited.

Objectives To ascertain the recommendations for antimicrobial treatment of uncomplicated gonorrhoea in 11 East European countries, valuable information for introducing an international gonococcal AMR surveillance programme.

Methods A questionnaire was used to collect information regarding the types, doses and manufacturers of the antimicrobials recommended for gonorrhoea treatment in all countries.

Results Ceftriaxone (250–1000 mg, intramuscularly (IM)×1) was reported as a first-line antimicrobial in all countries (n=11). Many of the second-line and alternative treatments seemed suboptimal for empirical treatment. Regionally manufactured antimicrobials were predominantly used and easily available, and some may be of suboptimal quality. This generates effective prerequisites for emergence, and rapid spread of gonococcal AMR and gonorrhoea.

Conclusion Ceftriaxone was first-line antimicrobial in all the 11 East European countries, which is an appropriate choice also in a global perspective. However, the adherence, especially among private physicians, to these public sector recommendations is questionable. Implementation of national and international gonococcal AMR surveillance in this region is crucial; to provide evidence-based data for regular and timely updating of treatment guidelines, to identify emerging resistance, and to assist in the prevention, control and containment of gonococcal AMR and gonorrhoea.

  • Neisseria gonorrhoeae
  • gonorrhoea
  • antimicrobial resistance (AMR)
  • treatment
  • WHO
  • EE SRH Network
  • Eastern Europe
  • surveillance
  • treatment

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Footnotes

  • Funding This study was supported by the EE SRH Network, and the WHO.

    Eastern European Sexual and Health (EE SRH) Network Antimicrobial Resistance Group: K Babayan, M Aznauryan (Armenia); A Kengerli, V Eyvazov (Azerbaijan); N Sukhobokova, N Pankratova, I Shimanskaya, S Glazkova (Belarus); S Tchiokadze, G Galdava, O Kvivlidze (Georgia); T Brilene (Estonia); A Bayduysenova (Kazakhstan); G Mamayeva (Kyrgyzstan); S Polevschikova, N Frigo, A Savicheva (Russia); Z Yunusova (Tajikistan); N Kochetova, G Mavrov (Ukraine); S Ibragimov, A Davurov (Uzbekistan)

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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