• N. gonorrhoeae
• antimicrobial resistance
• benin

Drug resistance has become increasingly a major threat for controlling gonorrhoea. In sub-Saharan Africa, where the syndromic approach and empirical antibiotic therapy, as promoted by the WHO, are largely used, information available on antimicrobial susceptibility of Neisseria gonorrhoeae is scarce.1 To our knowledge, the last study on antimicrobial susceptibility of N. gonorrhoeae in Benin was performed in 1999–2000 and found that all isolates were susceptible to ceftriaxone and ciprofloxacin.2 The present study was undertaken to update this information and to enhance global surveillance by the WHO.

We studied antibiotic susceptibility of 24 N. gonorrhoeae isolates from consecutive patients presenting urethritis, dysuria, cervicitis or vaginal discharge syndromes at two clinics in Cotonou, Benin.

Of the 146 samples tested, 24 (16.4%) were positive by culture; among them, 19 were from heterosexual men, 3 from female sex workers and 2 from men who have sex with men. All isolates were susceptible to azithromycin, cefixime and ceftriaxone, while all were resistant to tetracycline and penicillin. For ciprofloxacin, only 5 isolates (20.8%) were susceptible, 1 (4.2%) was intermediate and 18 (75.0%) were resistant. Among resistant strains, 14 were from heterosexual men, 2 from female sex workers and 2 from men who have sex with men, whereas the strain with intermediate resistance was from a heterosexual man.

The latest guidelines from WHO recommend a dual therapy combining ceftriaxone or cefixime plus azithromycin in settings where local resistance data are not available.2 The results from this study are online with these recommendations but suggest that dual therapy may not be necessary. Given the relatively small number of isolates in the present study, it will be important to implement a larger surveillance programme in Benin as well as in the whole West African region where ciprofloxacin is still widely used to treat gonorrhoea.