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REVIEW (Open Access)

Should we still use azithromycin for gonorrhoea treatment?

Sarah Mensforth A B and Jonathan D. C. Ross A
+ Author Affiliations
- Author Affiliations

A Department of Sexual Health and HIV, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK.

B Corresponding author. Email: sarahmensforth@nhs.net

Sexual Health 16(5) 442-448 https://doi.org/10.1071/SH19016
Submitted: 2 February 2019  Accepted: 7 March 2019   Published: 18 June 2019

Journal Compilation © CSIRO 2019 Open Access CC BY-NC-ND

Abstract

This review presents the evidence for azithromycin in the treatment of gonorrhoea, both as monotherapy and as a component of dual therapy. Uncertainties are explored regarding the efficacy of a dual treatment strategy, combining ceftriaxone and azithromycin, in the context of resistance trends and extra-genital infections. The association between microbiological testing and clinical outcome for the individual patient, and the effect of azithromycin use on other sexually transmissible infections, are considered. Finally, in the absence of imminent new antimicrobials, optimising the dose of azithromycin while maintaining tolerability is discussed.

Additional keywords: antimicrobial, Neisseria gonorrhoeae, resistance.


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