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Submitted on 23 Apr 2018
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Gonorrhea resistance: don’t forget the old chaps
Didier Raoult
To cite this version:
Didier Raoult. Gonorrhea resistance: don’t forget the old chaps. European Journal of Clinical
Micro-biology and Infectious Diseases, Springer Verlag, 2017, 36 (12), pp.2537. �10.1007/s10096-017-3099-0�.
�hal-01729775�
LETTER TO THE EDITOR
Gonorrhea resistance: don
’t forget the old chaps
D. Raoult1Received: 23 August 2017 / Accepted: 28 August 2017 / Published online: 15 September 2017 # Springer-Verlag GmbH Germany 2017
I read with great interest the paper by B. Suay-Garcia and M.-T. Pérez-Garcia on Neisseria gonorrhoeae and the resistance to antibiotics [1]. This echoes an over-anxiety generated by the WHO, the CDC and the media about the tragedy of resistance to gonococci, which leaves me unconvinced. Indeed, the tables reveal that there are different levels of resistance to gonococci according to countries, and that no country, for the time being, has observed gonococci that are resistant to everything. Also, a large number of antibiotics has not even been tested in vitro on gonococci as investigators are seeking newly discovered drugs rather than antibiotic compounds already known to be effective against N. gonorrhoeae. A rapid literature search identifies in 30 min at least three such compounds, which are probably effective in 100% of cases. These are pristinamycin [2], fusidic acid [3] and fosfomycin [4]. The real problem of gonorrhea, from my point of view, is to inform doctors in a given country about levels of resistance of gonococci in this area and the choice of an empirical treatment without culture, because it is the most used therapy. This means to test regularly isolates against an extended panel of antibiotics. In practice, in the one-day drama series, gonococcal infections are probably not the most terrifying, especially as treatment failure in gonococ-cal diseases can be evaluated within a few hours for symptom-atic gonorrhea. Moreover, there are efficient drugs available and no need to scream before using these drugs that are cheap and should be as efficient as before [5].
Funding None to declare. Compliance with ethical standards
Conflict of interest The author declares that he has no conflict of interest.
Ethical approval None required. Informed consent None required.
References
1. Suay-Garcia B, Perez-Gracia MT (2017) Drug-resistant Neisseria gonorrhoeae: latest developments. Eur J Clin Microbiol Infect Dis 36(7):1065–1071
2. Capp AB, Goncalves HD, Silva P, Coutinho AR, Pannunzio FM, Cohen A (1965) Pristinamycin in gonorrhea. Hospital (Rio J) 68(6):1329–1339
3. Jones RN, Biedenbach DJ, Roblin PM, Kohlhoff SA, Hammerschlag MR (2010) Update on fusidic acid (CEM-102) tested against Neisseria gonorrhoeae and Chlamydia trachomatis. Antimicrob Agents Chemother 54(10):4518–4519
4. Hauser C, Hirzberger L, Unemo M, Furrer H, Endimiani A (2015) In vitro activity of fosfomycin alone and in combination with ceftri-axone or azithromycin against clinical Neisseria gonorrhoeae iso-lates. Antimicrob Agents Chemother 59(3):1605–1611
5. Dubourg G, Abat C, Raoult D (2017) Why new antibiotics are not obviously useful now. Int J Antimicrob Agents 49(5):549–553
* D. Raoult
didier.raoult@gmail.com
1 URMITE, Aix Marseille Univ., UM63, CNRS 7278, IRD 198,
INSERM 1095, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13385 Marseille, France Eur J Clin Microbiol Infect Dis (2017) 36:2537
