What’s left in the cupboard? Older antimicrobials for treating gonorrhoea

Abstract Background Neisseria gonorrhoeae has developed resistance to all antimicrobials used treat gonorrhoea, with even ceftriaxone being undermined. It is therefore important examine any potential redeploy older routinely for other infections ceftriaxone-resistant gonococcal infections. Objectives We examined the susceptibility of N. aztreonam, chloramphenicol, co-trimoxazole, fosfomycin, piperacillin/tazobactam and rifampicin. Methods isolates (n = 94) were selected include a range antimicrobial susceptibilities: 58 collected in Gonococcal Resistance Antimicrobials Surveillance Programme; 17 clinical referred PHE reference laboratory; 19 control strains. MICs determined by agar dilution six study azithromycin as comparators. Results There was correlation between MICs, but five high (>0.5 mg/L) inhibited at 0.06–0.5 mg/L. Aztreonam exceeded those ceftriaxone. Among non-β-lactams, fosfomycin co-trimoxazole had low, tightly clustered suggesting widespread susceptibility, rifampicin split collection into highly susceptible resistant groups chloramphenicol wide MIC distribution. Conclusions Although unsuitable empirical use, piperacillin/tazobactam, and, possibly, could be considered individual patients infection once are known. Wider surveillance these agents needed, along trials establishment breakpoints N gonorrhoeae.