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Eurosurveillance, Volume 13, Issue 15, 10 April 2008
Rapid communications
Emergence of high-level azithromycin resistance in Neisseria gonorrhoeae in England and Wales
  1. Sexually Transmitted Bacteria Reference Laboratory, Centre for Infections, Health Protection Agency, London, the United Kingdom

Citation style for this article: Chisholm SA, Ison C. Emergence of high-level azithromycin resistance in Neisseria gonorrhoeae in England and Wales. Euro Surveill. 2008;13(15):pii=18832. Available online:
Date of submission: 10 April 2008

The Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) in England and Wales has monitored azithromycin resistance since 2001. In 2007, high-level azithromycin resistance (MICs >256 mg/L) was identified for the first time in six isolates, all of which were the same sequence type (ST 649).

High-level azithromycin resistance has also been reported in Scotland, but it is not known if this has wider geographical dissemination. It has been recommended that gonococcal resistance to azithromycin should be monitored in regions or countries where this drug is used to treat Chlamydia trachomatis infection. Furthermore, specific anti-gonococcal therapy should always be used to treat gonorrhoea. Azithromycin is not a recommended treatment for gonorrhoea in the United Kingdom [1]. Further information on this emerging resistance can be found at and


  1. Clinical effectiveness group, British Association for Sexual Health and HIV.
    National Guideline on the Diagnosis and Treatment of Gonorrhoea in Adults 2005. Available from:

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