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The extensively drug resistant strains of Gonorrhea that have been reported so far in places like France and Japan are simply a slight variant of a multi-drug resistant clone that appears to have spread very quickly throughout the world over the last 10 years. So it is very likely that a super drug resistant or XDR strain of gonorrhea will arrive sooner or later.  The Communicable Diseases Network Australia: 2 Aug 13


Gonococcus, with high level of resistance to the antibiotic azithromycin, is identified in Hawaii, USA. (Gonococci cause gonorrhea)  Clinical Infectious Diseases 2012 Mar 15; 54:841

Gonorrhea super bug: Neisseria gonorrhea H041, a new strain of gonococci which causes gonorrhea is resistant to cephalosporins, the current treatment of choice. International Society for Sexually Transmitted Disease Research Conference July 2011, Quebec City, Canada

Gonorrhea is becoming more and more drug resistant: The Health Protection Agency, UK

Cefixime is no longer recommended as first choice in the gonorrhea. Reduced susceptibility to Cefixime is observed in 17.4 % of cases gonorrhea. According to WHO, when treatment failure reaches 5%, the first-line antibiotic used should be changed.

Centre for Diseases Control, USA has recommended a change in the treatment of Gonorrhea: Ceftriaxone 250 mg injection and Azithromycin 1 g orally is the most effective treatment for uncomplicated gonorrhea. The change is in view of the increasing resistance of gonococci to cephalosporin. CDC MMWR July 8, 2011 / 60(26); 873

Asymptomatic pharyngeal infection with gonococci may act as reservoir sustaining the community prevalence of gonorrhea, especially for high-risk groups such as gay men and commercial sex workers. Sexually Transmitted Infections November 2010; 86 (6)

Hormonal contraception may have a protective effect against gonorrhea. Women using combined hormonal contraceptives or Depo-Provera were less likely to test positive for gonorrhea pathogen after sexual exposure compared with nonusers. STD Journal
Women and gay men who used lubricants for anal sex were three times more likely to acquire gonorrhea, chlamydia or syphilis than those who used none. Hyperosmolar lubricants stripped off the rectal epithelium, increasing the vulnerability to pathogens. Lubricants should still be used in anal sex to reduce trauma and risk of infection, but studies are required to find the safe ones. Microbicides 2010 Conference

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