FLUORCQUINOLONE RESISTANCE IN NEISSERIA-GONORRHOEAE

Fluoroquinolones and broad-spectrum cephalosporins are the most effect ive antimicrobial agents for the treatment of gonorrhea. However, clin ically significant resistance to fluoroquinolones has emerged in Neiss eria gonorrhoeae. fluoroquinolone-resistant strains account for approx imately 10% of all gonococcal strains in Hong Kong and the Republic of the Philippines. As many as 50% of strains from some Far Eastern coun tries exhibit decreased susceptibility (intermediate resistance) to fl uoroquinolones. Strains with intermediate resistance and clinically si gnificant resistance are being isolated sporadically in North America, where resistant strains have been associated with an outbreak and wit h failure of infections to respond to treatment with doses of ciproflo xacin and ofloxacin recommended by the Centers for Disease Control and Prevention; strains exhibiting decreased susceptibility to these agen ts are endemic in at least one metropolitan area. Monitoring for fluor oquinolone resistance is now critical for ensuring adequate treatment of infections with resistant strains and for maximizing the time du ri ng which fluoroquinolones may be used to treat gonorrhea.