The Pharmaceutical Journal
Vol 269 No 7225 p733
23 November 2002

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Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) (PDF 160K)

Ciprofloxacin resistance is on the increase, latest PHLS data show

GONOCOCCAL resistance to cipro-floxacin has increased, according to data gathered by a Public Health Laboratory Service surveillance programme.

The gonococcal resistance to antimicrobials surveillance programme 2001 report, published last week, shows that 3.1 per cent of isolates were resistant (>=1mg/L) in 2001, compared with 2.1 per cent in 2000. In addition, a further 2.6 per cent of isolates showed intermediate resistance to ciprofloxacin (>=0.125 to <1mg/L).

The report also notes that prevalence of ciprofloxacin resistance was relatively high in the north west (8.6 per cent) and south east (5.2 per cent) of England last year, but low London (1.8 per cent). Fewer isolates collected in 2001 showed penicillin resistance — 8.1 per cent compared with 9.2 per cent in 2000 — and although tetracycline resistance decreased, it remained relatively high last year — 32.5 per cent of isolates, compared with 37.6 per cent in 2000.

All gonococcal isolates were susceptible to spectinomycin and ceftriaxone and only six (0.3 per cent) were resistant to azithromycin.

Current guidelines recommend penicillin or fluoroquinolones (ciprofloxacin or ofloxacin) for the treatment of uncomplicated gonococcal infection, and the PHLS says that both the increase in ciprofloxacin resistance and the pockets of high prevalence are a cause for concern, because ciprofloxacin remains the first line treatment in many genitourinary clinics.