Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014

D Golparian; A K Ohlsson; H Janson; P Lidbrink; T Richtner; O Ekelund; H Fredlund; M Unemo

doi:10.2807/1560-7917.ES2014.19.30.20862

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Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014
D Golparian¹ , A K Ohlsson² , H Janson³ , P Lidbrink⁴ , T Richtner⁵ , O Ekelund³ , H Fredlund¹ , M Unemo¹
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Affiliations: ¹ World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden ² Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden ³ Department of Clinical Microbiology, Central Hospital, Växjö, Sweden ⁴ Department of Dermatovenereology, Karolinska University Hospital, Stockholm, Sweden ⁵ Department of Dermatology, Karolinska Institutet at Södersjukhuset, Stockholm, Sweden

Correspondence:
M Unemo
magnus.unemo orebroll.se
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Citation style for this article: Golparian D, Ohlsson A K, Janson H, Lidbrink P, Richtner T, Ekelund O, Fredlund H, Unemo M. Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014. Euro Surveill. 2014;19(30):pii=20862. https://doi.org/10.2807/1560-7917.ES2014.19.30.20862 Received: 21 Jul 2014

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Abstract

We describe four cases in Sweden of verified treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg; n=3) or cefotaxime (500 mg; n=1) monotherapy. All the ceftriaxone treatment failures were caused by the internationally spreading multidrug-resistant gonococcal NG-MAST genogroup 1407 clone. Increased awareness of treatment failures is crucial particularly when antimicrobial monotherapy is used. Frequent test of cure and appropriate verification/falsification of suspected treatment failures, as well as implementation of recommended dual antimicrobial therapy are imperative.