{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:21:22Z","timestamp":1792736482312,"version":"4.5.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Gonorrhea treatment in the United States relies on empirically administered intramuscular ceftriaxone. Diagnostics to predict Neisseria gonorrhoeae ciprofloxacin susceptibility\/resistance could enable use of ciprofloxacin, a low-cost, single-dose oral antibiotic, to treat ciprofloxacin-susceptible gonorrhea. Ciprofloxacin resistance in N. gonorrhoeae is overwhelmingly mediated by a single mutation in gyrA at codon 91. Molecular interrogation of this site reliably predicts ciprofloxacin resistance and susceptibility. The Antibacterial Resistance Leadership Group (ARLG) is performing a multicenter, multicompany study to generate regulatory-grade clinical performance data to support Food and Drug Administration submissions of multiple nucleic acid amplification tests to predict ciprofloxacin susceptibility in N. gonorrhoeae. In December 2025, a multidisciplinary group was convened by the ARLG and Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator to discuss a coordinated pathway to enable individualized ciprofloxacin resistance-guided gonorrhea therapy in the United States, acknowledging this will require integration across diagnostics, regulation, guidelines, reimbursement, and implementation. Meeting highlights are presented.<\/jats:p>","DOI":"10.1093\/cid\/ciag640","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:53:20Z","timestamp":1792691600000},"source":"Crossref","is-referenced-by-count":1,"title":["Enabling Ciprofloxacin Resistance-Guided Therapy for\n                    <i>Neisseria gonorrhoeae<\/i>\n                    : Aligning Diagnostics, Regulation, Guidelines, and Reimbursement"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7768-4940","authenticated-orcid":false,"given":"Betsy Wonderly","family":"Trainor","sequence":"first","affiliation":[{"name":"Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L","family":"Osborn","sequence":"additional","affiliation":[{"name":"Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6922-7364","authenticated-orcid":false,"given":"Jeffrey D","family":"Klausner","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-5334","authenticated-orcid":false,"given":"Michael J","family":"Satlin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6656-1751","authenticated-orcid":false,"given":"Sarah N","family":"Buss","sequence":"additional","affiliation":[{"name":"Association of Public Health Laboratories , Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Scheffer-Wong","sequence":"additional","affiliation":[{"name":"Visby Medical, Inc. , San Jose, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Harris","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3064-8564","authenticated-orcid":false,"given":"Barbara","family":"Van Der Pol","sequence":"additional","affiliation":[{"name":"University of Alabama Department of Medicine, , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9275-0994","authenticated-orcid":false,"given":"Carolyn","family":"Deal","sequence":"additional","affiliation":[{"name":"National Institutes of Allergy and Infectious Disease (NIAID), National Institutes of Health , Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8580-0514","authenticated-orcid":false,"given":"Ashley","family":"Nenninger","sequence":"additional","affiliation":[{"name":"Hologic, Inc. , San Diego, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6380-9662","authenticated-orcid":false,"given":"Elisa","family":"Mokany","sequence":"additional","affiliation":[{"name":"SpeeDx, Inc. , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung","family":"Moon","sequence":"additional","affiliation":[{"name":"National Institutes of Allergy and Infectious Disease (NIAID), National Institutes of Health , Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D","family":"Yao","sequence":"additional","affiliation":[{"name":"Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, Minnesota ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7189-5492","authenticated-orcid":false,"given":"Lindley A","family":"Barbee","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5646-1314","authenticated-orcid":false,"given":"Yonatan H","family":"Grad","sequence":"additional","affiliation":[{"name":"Department of Immunology and Infectious Diseases, Harvard T.H. 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