Good news for the monogamous – bad news for the rest – Neiserria gonorrhoeae is rapidly becoming resistant to cefixime, an oral third-generation cephalosporin. The resistance rates are low – a maximum of 17% in Honolulu – but the fear is that continued cefixime use will carry-over into an increased resistance for ceftriaxone.
This follows the 2007 declaration that fluoroquinolone resistance had obviated their use.
For now, the CDC recommendations have narrowed to 250mg IM/IV ceftriaxone plus 1g oral azithromycin once or 100mg oral doxycycline BID for seven days.
“Update to CDC’s Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral Cephalosporins No Longer a Recommended Treatment for Gonococcal Infections”
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm?s_cid=mm6131a3_e