The effectiveness of gentamicin in the treatment of Neisseria gonorrhoeae: a systematic review

Hathorn, Emma; Dhasmana, Divya; Duley, Lelia; Ross, Jonathan

doi:10.1186/2046-4053-3-104

Cited by 42 publications

(32 citation statements)

References 23 publications

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“…ESC-resistant gonococci are unlikely to exhibit cross-resistance to gentamicin, as cephalosporins act on bacterial cell wall synthesis, whereas gentamicin disrupts protein synthesis. A single intramuscular injection of antibiotic paves the way for outpatient management and reduces the risk of vestibular and renal toxicity seen with high drug concentrations for longer periods for other infections (10). No resistance to gentamicin was observed in the present study, and its high in vitro susceptibility against MDR strains and strains with decreased susceptibility to currently recommended ESCs suggests its potential for future use as treatment for gonococcal infections.…”

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confidence: 51%

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Gentamicin Susceptibility among a Sample of Multidrug-Resistant Neisseria gonorrhoeae Isolates in India

Bala

Singh

Bhargava

et al. 2016

Antimicrob Agents Chemother

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bAntimicrobial susceptibility testing of 258 Neisseria gonorrhoeae isolates by Etest determined that 60.1% were multidrug resistant (MDR), while 5% of the strains had decreased susceptibility to currently recommended extended-spectrum cephalosporins (ESCs). Among these, 84.5% of MDR strains and 76.9% of strains that had decreased susceptibility to ESCs were susceptible to gentamicin. No MDR isolate was resistant to gentamicin. These in vitro results suggest that gentamicin might be an effective treatment option for the MDR strains and in dual therapy for gonorrhea. However, further research regarding the clinical treatment outcomes is essential. N eisseria gonorrhoeae clinical isolates resistant to extendedspectrum cephalosporins (ESCs), the last remaining options for empirical therapy, and most other antimicrobials have been reported worldwide in recent years (1-4). Organizations such as the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control (ECDC) are considering infections caused by multidrug-resistant (MDR) and extensively drugresistant (XDR) N. gonorrhoeae major public health problems (5-7). With the increasing prevalence of drug resistance, there is an urgent need for new and effective treatment options. Gentamicin has been used for the past 2 decades in the management of gonorrhea in Malawi (8, 9). Gentamicin has been considered an option for the treatment of infections due to the MDR and XDR strains and for future treatment of gonorrhea particularly in dual therapy in other geographic regions (10-12).Earlier studies focused on the in vitro susceptibility of N. gonorrhoeae to gentamicin (8,(13)(14)(15)(16)(17). Some of these studies were on a limited number of isolates (13,17). To the best of our knowledge, no study has analyzed the in vitro susceptibility of gentamicin against MDR strains. Therefore, this study was aimed at determining the (i) trend of in vitro susceptibility of N. gonorrhoeae isolates to gentamicin during 2010 to 2015, (ii) status of gentamicin susceptibility for MDR strains and strains with decreased susceptibility to ESCs, and (iii) profile of gentamicin-less-susceptible (LS) strains for eight other antimicrobials recommended currently and in the past for treatment of gonorrhea.A total of 258 N. gonorrhoeae isolates obtained from consecutive patients attending a sexually transmitted disease (STD) clinic from August 2010 to December 2015 were identified on the basis of colony morphology, Gram staining, and oxidase, superoxol, and carbohydrate utilization tests (18). Susceptibility testing for gentamicin and other antimicrobials, such as ESCs (ceftriaxone, cefpodoxime, cefixime), penicillin, tetracycline, ciprofloxacin, spectinomycin, and azithromycin, was performed using the Etest strip per manufacturer instructions (bioMérieux SA, France) on GC agar (Becton, Dickinson and Company [BD], Sparks, MD) containing 1% vitamin growth supplement (HiMedia, India) or Isovitalex (BD). Susceptibilit...

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confidence: 51%

“…Gentamicin has been used for the past 2 decades in the management of gonorrhea in Malawi (8,9). Gentamicin has been considered an option for the treatment of infections due to the MDR and XDR strains and for future treatment of gonorrhea particularly in dual therapy in other geographic regions (10)(11)(12).…”

mentioning

confidence: 99%

Gentamicin Susceptibility among a Sample of Multidrug-Resistant Neisseria gonorrhoeae Isolates in India

Bala

Singh

Bhargava

et al. 2016

Antimicrob Agents Chemother

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“…In fact, since 1993 gentamicin has been recommended first-line treatment (together with doxycycline) in syndromic management in Malawi (11, 12, 16, 38, 132, 117, 138–141). However, all these antimicrobials have shortcomings in their use as first-line therapy of gonorrhea, which have been detailed elsewhere (11, 12, 22, 136, 137, 140, 141). Accordingly, most likely they are primarily options for ESC-resistant gonorrhea, ESC allergy and in new dual antimicrobial therapies.…”

Section: Future Treatments For Gonorrheamentioning

confidence: 99%

Antimicrobial Resistance Expressed by Neisseria gonorrhoeae : A Major Global Public Health Problem in the 21st Century

2016

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Neisseria gonorrhoeae is a strictly human pathogen that is typically transmitted by sexual contact. The associated disease gonorrhea has plagued humankind for thousands of years, with a current estimated incidence of 78 million cases per year. Advances in antimicrobial discovery in the 1920s and 1930s leading to the discovery of sulfonamides and penicillin begun the era of effective antimicrobial treatment of gonorrhea. Unfortunately, the gonococcus developed decreased susceptibility or even resistance to these initially employed antibiotics, a trend that continued over subsequent decades with each new antibiotic that was brought into clinical practice. As this pattern of resistance has continued into the 21st century, there is now reason for great concern, especially in an era when few new antibiotics have prospects for use as treatment of gonorrhea. Here, we review the history of gonorrhea treatment regimens and gonococcal resistance to antibiotics, the mechanisms of resistance, resistance monitoring schemes that exist in different international settings, global responses to the challenge of resistance, and prospects for future treatment regimens in the 21st century.

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“…Options include the use of Spectinomycin, gentamicin and azithromycin although each of these have drawbacks including limited availability, high cost, and poor bioavailability at some anatomical sites. [192021]…”

Section: Antibiotic Resistance In Prevalent Bacterial and Protozoan Smentioning

confidence: 99%

Antibiotic resistance in prevalent bacterial and protozoan sexually transmitted infections

Krupp

Madhivanan

2015

Indian J Sex Transm Dis

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The emergence of multi-drug resistant sexually transmitted infections (STIs) is causing a treatment crisis across the globe. While cephalosporin-resistant gonorrhea is one of the most pressing issues, extensively antibiotic resistant Chlamydia trachomatis and Mycoplasma hominis are also becoming commonplace. Experts have suggested that the failure of current treatment regimens are “largely inevitable” and have called for entirely new classes of antimicrobial agents. With the exception of several new classes of drugs primarily targeting nosocomial infections, progress has been slow. While pharmaceutical companies continue to introduce new drugs, they are based on decade-old discoveries. While there is disagreement about what constitutes new classes of antibiotics, many experts suggest that the last truly new family of antimicrobials was discovered in 1987. This review summarizes the existing literature on antibiotic resistance in common bacterial and protozoal STIs. It also briefly discusses several of the most promising alternatives to current therapies, and further examines how advances in drug delivery, formulation, concentration, and timing are improving the efficacy of existing treatments. Finally, the paper discusses the current state of pharmaceutical development for multidrug-resistant STI.

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The effectiveness of gentamicin in the treatment of Neisseria gonorrhoeae: a systematic review

Cited by 42 publications

References 23 publications

Gentamicin Susceptibility among a Sample of Multidrug-Resistant Neisseria gonorrhoeae Isolates in India

Gentamicin Susceptibility among a Sample of Multidrug-Resistant Neisseria gonorrhoeae Isolates in India

Antimicrobial Resistance Expressed by Neisseria gonorrhoeae : A Major Global Public Health Problem in the 21st Century

Antibiotic resistance in prevalent bacterial and protozoan sexually transmitted infections

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