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Antibiotic resistance among sexually transmitted infections: perspectives from clinical practice
  1. Angelo Roberto Raccagni1,
  2. Elena Bruzzesi1,
  3. Massimo Cernuschi2,
  4. Laura Galli2,
  5. Francesca Alberton1,
  6. Nicasio Mancini3,4,
  7. Antonella Castagna2,4,
  8. Silvia Nozza2
  1. 1Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
  2. 2Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
  3. 3Laboratory of Medical Microbiology and Virology, San Raffaele Hospital, Milano, Italy
  4. 4Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy
  1. Correspondence to Dr Angelo Roberto Raccagni, Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy; raccagni.angelo{at}hsr.it

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We present two cases of men who have sex with men (MSM) in care at the Infectious Diseases Unit, San Raffaele Hospital, Milan diagnosed with multidrug-resistant (MDR) STIs. Both presented with complaints of urethral discharge and were engaged in receptive/insertive sexual intercourse with >10 partners monthly, with seldom condom use.

The first case is an injecting-drug user with history of hepatitis B and C virus coinfection diagnosed in 2013 with ceftriaxone-resistant Neisseria gonorrhoeae (NG) proctitis, and ciprofloxacin-resistant and azithromycin-resistant Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT) urethritis, concurrent with primary HIV infection. NG proctitis was treated with benzylpenicillin (2.4 million units/week for 3 weeks), given reduced susceptibility, and with azithromycin (2 g); UU/CT urethritis was treated with doxycycline, given resistance to azithromycin.

The second …

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Footnotes

  • Handling editor Anna Maria Geretti

  • Contributors SN performed medical visits and contributed to the writing of the article. ARR contributed to the writing of the article and collected clinical data. EB and AC contributed to the review of the article. MC performed medical visits. LG collected and analysed clinical data and contributed to the review of the article. FA contributed to the writing of the article. NM coordinated microbiological activities and contributed to the review of the article. All authors have read and agreed to the published version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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