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Combination therapy for gonorrhoea : in vitro synergy testing
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Pereira, Rui P. A., Cole, M. J. and Ison, C. A. (2013) Combination therapy for gonorrhoea : in vitro synergy testing. Journal of Antimicrobial Chemotherapy, 68 (3). pp. 640-643. doi:10.1093/jac/dks449 ISSN 0305-7453.
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Official URL: http://dx.doi.org/10.1093/jac/dks449
Abstract
Objectives
Antimicrobial resistance in Neisseria gonorrhoeae is an increasing problem worldwide and combinations of antimicrobial agents have been recommended to delay the onset of treatment failures. The objective of this study was to obtain in vitro data on the activity of current (ceftriaxone or cefixime plus azithromycin) and alternative (gentamicin plus azithromycin) regimens.
Methods
A panel of 64 gonococcal isolates displaying various cefixime MICs was selected for inclusion in the study. Determination of the activities of the antimicrobial combinations of ceftriaxone, cefixime or gentamicin with azithromycin was performed using the agar dilution method and subsequent calculation of the fractional inhibitory concentration index (FICI) values.
Results
No antagonism for any of the antimicrobial combinations was detected among the 64 gonococcal isolates. When cefixime or ceftriaxone was combined with azithromycin all isolates showed additivity/indifference with a mean FICI of 2.0. All gonococcal isolates also showed additivity/indifference with the antimicrobial combination of gentamicin with azithromycin, but with a lower mean FICI of 1.7. No significant difference in the mean FICI between isolates fully susceptible to cefixime and isolates with decreased susceptibility to cefixime was observed.
Conclusions
The results obtained support the gonorrhoea treatment currently recommended in the UK national guidelines and suggest that gentamicin with azithromycin could be a future treatment option. The in vivo activity and efficacy of these combinations remain unknown and prospective clinical studies should be addressed.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||
| Journal or Publication Title: | Journal of Antimicrobial Chemotherapy | ||||
| Publisher: | Oxford University Press | ||||
| ISSN: | 0305-7453 | ||||
| Official Date: | 2013 | ||||
| Dates: |
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| Volume: | 68 | ||||
| Number: | 3 | ||||
| Page Range: | pp. 640-643 | ||||
| DOI: | 10.1093/jac/dks449 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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