Editorial: A strategy for the surveillance of antimicrobial resistance in Australia.

Emerging resistance is undermining previously effect ive treatment regimes worldwide. Gonococcal disease is one example of how emerging resistance has necessitated changes in standard treatment pro grams from cheap oral antibiotics to more expensive agents. Penicillin, which remains a recom mended treatment for gonorrhoea in many countries, is becoming less effective as a treatment due to increasing resistance. In the World Health Organization (WHO) Western Pacifi c Region in 2000, the proportion of isolates resistant to penicillin varied from region to region, ranging from over 90 per cent in Korea to 7.9 per cent in New Zealand.1 Of particular concern is the increasing number of gonococcal isolates showing an altered susceptibility to the third-generation cephalosporins. Third-generation cephalosporins have an increasing importance in the treatment of gonococcal disease as the incidence of resistance to penicillins and quinolones increases. As demonstrated in the WHO Western Pacifi c Gonococcal Antimicrobial Surveillance Programme report in this issue of Communicable Diseases Intelligence, Neisseria gonorrhoeae isolates with an altered susceptibility to third generation cephalosporins continue to be reported from several countries in the region, including Australia.2