Neisseria gonorrhoeae is the second most common reported sexually transmitted infection in the United States. Globally there have been increasing reports of antimicrobial resistant infections. In order reduce the direct selection pressure of a single treatment regimen on Neisseria gonorrhoeae, it might be beneficial to use different treatments. Recent advances in molecular biology allow for the prediction of antimicrobial susceptibility in bacteria based on short DNA sequence patterns in certain genes associated with resistance. In 2015, we introduced the routine use of a molecular GyrA assay to predict ciprofloxacin susceptibility in Neisseria gonorrhoeae infections at UCLA Health. We found that use of the assay was associated with a significant decrease in ceftriaxone use, significant increase in ciprofloxacin use and in a small group of ciprofloxacin-treated cases (N=25), 100% cure. Additional clinical trials are underway. Similar molecular assays to predict ciprofloxacin susceptibility in gonorrhea have been approved for marketing in Europe and Australia. Commercial Neisseria gonorrhoeae GyrA testing is also available in the United States.
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