Proportion of Drug-Resistant Gonorrhea Cases Rising in California, Hawaii

The proportion of fluoroquinolone-resistant gonorrhea cases is on the rise in Hawaii and California and may spread through the rest of the country, according to new data in today's issue of Morbidity and Mortality Weekly Report, Reuters Health reports. According to Dr. Lori Newman of the CDC and colleagues, less than 1% of gonorrhea samples in San Francisco, Long Beach, Calif., and San Diego were resistant to fluoroquinolones in 1999 and 2000, while approximately 6% of samples from Orange County, Calif., were resistant to the drugs. On average, 2.5% of samples from these areas tested last year were resistant to fluoroquinolones. In Hawaii, 20% of gonorrhea samples were resistant to the drugs last year, up from 11% in 2000 and 10% in 1999. Flouroquinolones, including ciprofloxacin and levofloxacin, are commonly used to treat gonorrhea because the drugs are inexpensive, can be given orally and only require a single dose. The CDC is encouraging physicians to "be alert" for cases of resistant gonorrhea, take a patient's travel history and use cephalosporins, instead of fluoroquinolones, to treat gonorrhea cases in California, Hawaii and Asia, Reuters Health reports. "Fluoroquinolones are still very important drugs for most of the country," Newman said. "We don't have a whole lot of antibiotic choices for gonorrhea. But when these drugs are used, state and local health departments need to monitor for gonococcal resistance so that when it does arise we can respond appropriately" (Reuters Health, 11/21).