Gonorrhea, one of the most common sexually transmitted diseases in the US, infects more than 700,000 Americans each year. Most do not have symptoms. Left untreated, it can increase the risk for HIV and cause other serious health consequences, including infertility. It has eventually grown resistant to every drug used to treat it.

 Since 2007, only one class of antibiotics -- cephalosporins, which include defixime and ceftriaxone -- has been recommended.

The Centers for Disease Control (CDC) announced Aug. 9 that it no longer recommends the oral antibiotic cefixime (marketed under the brand name Suprax) for the treatment of gonorrhea, due to recent lab data showing that it is becoming less effective. This leaves only one drug proven effective for treating gonorrhea, the injectable antibiotic ceftriaxone.

The CDC issued the new guidelines out of concern that continued use of cefixime may prompt gonorrhea to develop resistance to all cephalosporins, including ceftriaxone. "This is a critical preemptive strike to preserve our last proven treatment option," said Kevin Fenton, MD, director of the CDC's National Center for HIV/AIDS.

The most effective treatment, according to the latest report, is a combination therapy: ceftriaxone along with one or two other oral antibiotics, either azithromycin or doxycycline.

The CDC is also urging health departments and labs to help in identifying emerging resistance.

The surest way to prevent infection is to avoid sexual intercourse; for the sexually active, correct consistent and correct condom use and limiting the number of sex partners are effective strategies for reducing the risk of infection.

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