The Emerging Threat of Untreatable Gonococcal Infection

Abstract

To the Editor: In their summary of the global threat of antibiotic-resistant Neisseria gonorrhoeae, Bolan et al. (Feb. 9 issue)1 state that “in patients who are allergic to cephalosporins, the only option is 2 g of azithromycin orally.” However, the aminoglycoside spectinomycin (unavailable in the United States since 2006) has proven efficacy against genital gonococcal infection2 and is recommended for patients in the United Kingdom who are allergic to penicillin.3 Since most gonococcal isolates remain susceptible to spectinomycin, it represents a viable option for cephalosporin-resistant genital gonorrhea,2,3 although ongoing uncertainty regarding manufacturing and supply may compromise its future usefulness. . . .