{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:09:43Z","timestamp":1791468583406,"version":"4.3.4"},"reference-count":177,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Neisseria gonorrhoeae has developed resistance to all first-line recommended therapies, making gonococcal antimicrobial resistance a major public health concern given limited antibiotic options currently and an even smaller antimicrobial development pipeline. Since the release of the Centers for Disease Control and Prevention (CDC) 2015 STD Treatment Guidelines, azithromycin, part of the 2015 dual-drug treatment regimen, has had a rapid rise in resistance. The 2020 CDC Gonorrhea Treatment Recommendations and the 2021 Sexually Transmitted Infections (STI) Treatment Guidelines were developed weighing the priorities of treating the individual, protecting the population, and preventing antimicrobial resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Gonorrhea subject matter experts (SME) generated 8 key questions and conducted a literature review of updated data from 2013 to 2019 on gonorrhea antimicrobial resistance, treatment failures, clinical trials, and other key topics. More than 2200 abstracts were assessed, and 248 clinically relevant articles were thoroughly reviewed. SMEs also evaluated N gonorrhoeae antimicrobial resistance data from the Gonococcal Isolate Surveillance Project (GISP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence<\/jats:title>\n                    <jats:p>Although there have been reports of ceftriaxone treatment failures internationally, GISP data suggest that ceftriaxone minimal inhibitory concentrations (MICs) have remained stable in the United States, with\u2005&amp;lt;\u20050.1% exhibiting an \u201calert value\u201d MIC (&amp;gt; 0.25 mcg\/mL). However, GISP documented a rapid rise in the proportion of isolates with an elevated MIC (\u2265 2.0 mcg\/mL) to azithromycin\u2014nearly 5% in 2018. At the same time, new pharmacokinetic\/pharmacodynamic data are available, and there is greater recognition of the need for antimicrobial stewardship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>The 2021 CDC STI Treatment Guidelines now recommend 500mg ceftriaxone intramuscularly once for the treatment of uncomplicated gonorrhea at all anatomic sites. If coinfection with chlamydia has not been excluded, cotreatment with doxycycline 100mg twice daily for 7 days should be added. Few alternative therapies exist for persons with cephalosporin allergies; there are no recommended alternative therapies for N gonorrhoeae infection of the throat.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac043","type":"journal-article","created":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T08:40:12Z","timestamp":1644914412000},"page":"S95-S111","source":"Crossref","is-referenced-by-count":62,"title":["Management of\n                    <i>Neisseria gonorrhoeae<\/i>\n                    in the United States: Summary of Evidence From the Development of the 2020 Gonorrhea Treatment Recommendations and the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infection Treatment Guidelines"],"prefix":"10.1093","volume":"74","author":[{"given":"Lindley A","family":"Barbee","sequence":"first","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"University of Washington, Seattle, Washington, USA"},{"name":"Public Health \u2014 Seattle & King County HIV\/STD Program, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sancta B","family":"St. Cyr","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"2022041312505562500_CIT0001","volume-title":"2018 STD surveillance report","author":"CDC","year":"2018"},{"key":"2022041312505562500_CIT0002","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1097\/OLQ.0000000000000515","article-title":"Gonorrhea control, United States, 1972-2015, a narrative review.","volume":"43","author":"Peterman","year":"2016","journal-title":"Sex Transm Dis"},{"key":"2022041312505562500_CIT0003","volume-title":"Antibiotic resistance threats in the United States. 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