In vitro activity of the ketolide cethromycin in multidrug-resistant clinical Neisseria gonorrhoeae isolates and international reference strains
2019 (English)In: Journal of chemotherapy, ISSN 1120-009X, E-ISSN 1973-9478, Vol. 252, no Part B, p. 1399-1405Article in journal (Refereed) Published
Abstract [en]
Antimicrobial resistance in Neisseria gonorrhoeae is a major public health problem, which compromises the treatment of gonorrhoea globally. We evaluated the in vitro activity of the ketolide cethromycin against a large panel of clinical gonococcal isolates and international reference strains (n = 254), including numerous multidrug-resistant and extensively drug-resistant isolates. Cethromycin showed potent in vitro activity against most of the gonococcal isolates with the following modal MIC, MIC50 and MIC90: 0.064 mg/L, 0.125 mg/L and 0.5 mg/L, respectively. However, cross-resistance between azithromycin and cethromycin was identified (Spearman's rank correlation coefficient 0.917) and isolates displaying high-level resistance to azithromycin (MIC >256 mg/L; n = 9) also showed high MICs of cethromycin (32-256 mg/L). In conclusion, the cross-resistance with azithromycin indicates that cethromycin may not be considered for empirical first-line monotherapy of gonorrhoea. However, cethromycin might be valuable in combination antimicrobial therapy and for second-line therapy e.g. for cases with ceftriaxone resistance or allergy.
Place, publisher, year, edition, pages
Taylor & Francis, 2019. Vol. 252, no Part B, p. 1399-1405
Keywords [en]
ABT-773, antimicrobial resistance, cethromycin, gonorrhoea, ketolide, treatment
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-74349DOI: 10.1080/1120009X.2019.1615724ISI: 000469038500001PubMedID: 31106713Scopus ID: 2-s2.0-85066070157OAI: oai:DiVA.org:oru-74349DiVA, id: diva2:1317084
Note
Funding Agencies:
Örebro County Council Research Committee
Foundation for Medical Research at Örebro University Hospital, Örebro, Sweden
2019-05-212019-05-212020-12-01Bibliographically approved