1. Neisseria gonorrhoeae treatment failure to the recommended antibiotic regimen-Québec, Canada, 2015-19.
- Author
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Blouin K, Lefebvre B, Trudelle A, Defay F, Perrault-Sullivan G, Gnimatin JP, and Labbé AC
- Subjects
- Humans, Female, Adult, Male, Quebec epidemiology, Young Adult, Longitudinal Studies, Middle Aged, Adolescent, Neisseria gonorrhoeae drug effects, Gonorrhea drug therapy, Gonorrhea microbiology, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents administration & dosage, Treatment Failure, Azithromycin therapeutic use, Azithromycin administration & dosage, Cefixime therapeutic use, Cefixime pharmacology, Ceftriaxone therapeutic use, Microbial Sensitivity Tests
- Abstract
Objective: To describe Neisseria gonorrhoeae treatment failure to the recommended antimicrobial regimens (azithromycin, cefixime and ceftriaxone)., Methods: Our study was a longitudinal analysis of treatment failures from an observational open cohort of gonococcal infection cases collected in Québec, Canada (n = 2547) between September 2015 and December 2019. Epidemiological and clinical data were collected using a self-administered questionnaire, direct case interviews and chart reviews. Antimicrobial susceptibility testing was performed using the agar dilution method. To be retained as a treatment failure, cases must have had (i) a laboratory-confirmed gonococcal infection; (ii) a documented treatment; (iii) a positive test of cure (TOC) performed within a defined period and (iv) no sexual contact (vaginal, oral or anal), even protected with a condom, between the beginning of treatment and the positive TOC. A broader definition, including suspected cases, was also examined., Results: Among 1593 cases where a TOC was performed, 83 had a positive TOC: 11 were retained as treatment failure, and 6 were considered suspected cases (overall = 17/1593; 1.1%). Possible explanations for retained or suspected treatment failure included resistance to the antibiotics used for treatment (n = 1), pharyngeal infection (n = 9, of which 5 had been treated with ceftriaxone and 4 with other regimens); and azithromycin monotherapy (n = 1). Some cases had more than one potential explanation., Conclusions: Treatment failure occurred in 1.1% of cases of Neisseria gonorrhoeae infection for which a TOC was performed, including some cases of pharyngeal infection treated with ceftriaxone., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) more...
- Published
- 2024
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