TY - JOUR T1 - Azithromycin in the treatment of infection with <em>Neisseria gonorrhoeae</em> JF - Sexually Transmitted Infections JO - Sex Transm Infect SP - 422 LP - 426 DO - 10.1136/sti.2010.044586 VL - 86 IS - 6 AU - Chris Bignell AU - Janet Garley Y1 - 2010/11/01 UR - http://sti.bmj.com/content/86/6/422.abstract N2 - The efficacy of azithromycin as sole antimicrobial treatment for infection with Neisseria gonorrhoeae is reviewed. Aggregate cure rates for urethral and endocervical infection were 520/539 (96.5%; 95% CI 94.3% to 97.6%) for a 1 g dose from nine studies and 392/396 (99%; 95% CI 97.5% to 99.6%) for a 2 g dose from two studies. Azithromycin cured 46/47 (97.9%) cases of oropharyngeal infection and 34/35 (97.1%) cases of rectal infection evaluated within the clinical trials. Reports of in vitro resistance to azithromycin reveal a wide geographical spread of clinical isolates, with raised minimal inhibitory concentration to azithromycin and the emergence of high-level resistance in 2001. Concerns about resistance preclude azithromycin from general recommendation as sole antimicrobial therapy for gonorrhoea. However, azithromycin may have a valuable role in specific clinical situations and in combination with extended spectrum cephalosporins in the treatment of gonorrhoea. ER -