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July 14, 2003 07:32pm
Drug-Resistant Gonorrhea Spreads in US
Source: Planet Out
by: Randy Dotinga

Summary: Drug-resistant gonorrhea is popping up from coast to coast, forcing some doctors to abandon their preferred treatment, Cipro.

In most cases, gonorrhea is three things: minor, annoying and easy to treat. But this very common sexually transmitted disease is threatening to send patients back in time.

Drug-resistant gonorrhea is popping up from coast to coast, forcing some doctors to abandon their preferred treatment -- Cipro pills -- in favor of old-fashioned injections of another medication.

So far, only a few states are reporting outbreaks of drug-resistant gonorrhea strains, and the alternative drug continues to easily kill off the infections. But experts warn that further spread of the strains could spell trouble for the workload at STD clinics.

"It slows things down a bit to have the personnel required to administer (injections). In a busy clinic, it would limit the number of patients who could be seen in a day," said Dr. David H. Martin, director of the Louisiana STD Research Center and chief of the infectious diseases division at the Louisiana State University Medical Center.

This month, the U.S. Centers for Disease Control and Prevention (news - web sites) reported that the resistant strains have appeared in California, New York City, Washington state, Massachusetts, Michigan and Indiana.

Gonorrhea -- also known as "The clap" or, more evocatively, "The drip" -- strikes an estimated 650,000 Americans each year. Large numbers of gay men get gonorrhea, although the rate tends to go up and down, said Dr. Michael Horberg, a Kaiser Permanente physician in Santa Clara, Calif., who frequently treats patients with STDs.

In men, gonorrhea causes a burning sensation and discharge ("drip") from the penis. Gonorrhea can also strike the rectum (from anal sex) and the throat (from blow jobs).

Although symptoms in women can be mild, or even unnoticeable, gonorrhea can lead to serious side effects, such as pelvic inflammatory disease. In both sexes, untreated gonorrhea can spread to joints and the blood.

Penicillin was the most common treatment for gonorrhea until the 1970s and 1980s, when the disease began to become immune to the antibiotic. In the late 1980s, doctors started prescribing Cipro and its sister medications, along with a drug known by the brand name Suprax, which is no longer manufactured.

Cipro is the same potent antibiotic that became famous as a treatment for anthrax. But in 2000, doctors reported that Cipro-resistant strains of gonorrhea had appeared in Asia, Hawaii and the Pacific islands. Since Cipro no longer worked, doctors had to find alternatives.

Strains of Cipro-resistant gonorrhea later spread to the United States, starting in California. Health officials have advised doctors in California, Hawaii, Massachusetts and some parts of Michigan to stop routinely prescribing Cipro to gonorrhea patients. Instead of Cipro, doctors are turning to an injection drug known as ceftriaxone.

"The beauty of the other treatment was that you just needed one or two pills of Cipro and it's gone," Horberg said. "Now we're back to using medicine that requires a shot."

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