{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:16:27Z","timestamp":1790381787918,"version":"4.1.0"},"reference-count":116,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Belgian Healthcare Knowledge Center"},{"name":"Institutional Review Board of the Institute of Tropical Medicine","award":["1360\/20"],"award-info":[{"award-number":["1360\/20"]}]},{"name":"Research Foundation"},{"DOI":"10.13039\/501100011878","name":"Flanders","doi-asserted-by":"publisher","award":["12B1M24N"],"award-info":[{"award-number":["12B1M24N"]}],"id":[{"id":"10.13039\/501100011878","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are 2 of the most common bacterial sexually transmitted infections. The prevalence of azithromycin resistance in NG (AR-NG) has increased from 1% to 47.9% in the past 10 years among men who have sex with men (MSM) in Belgium. Dual therapy with ceftriaxone and azithromycin was until recently the standard-of-care in Belgium. Our objective was to reproduce the azithromycin-resistance epidemic among MSM in Belgium using dual therapy and to evaluate the counterfactual scenario of using ceftriaxone monotherapy on the emergence of AR-NG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We developed a network-based model for CT and NG transmission among MSM in Belgium to estimate the prevalence of CT, NG, and AR-NG in the population. The model simulates transmission of NG among 3 anatomical sites in a population of 10 000 MSM over 10 years. The effect of different treatment strategies was evaluated in terms of CT, NG, and AR-NG prevalence as well as antibiotic consumption.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our model captured adequately well the observed azithromycin-resistance epidemic over a 10-year period in Belgium, with AR-NG increasing from 0% to 44%. Antibiotic consumption, and prevalences of NG and AR-NG decreased when ceftriaxone monotherapy was used against NG, while CT prevalence increased, compared to dual therapy. In the ceftriaxone monotherapy scenario, the prevalence of AR-NG was approximately half of that in the dual-therapy scenario (23%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Switching from dual to monotherapy was associated with a halving of the prevalence of AR-NG. These results provide further evidence to favor mono- over dual therapy for the treatment of gonorrhea.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf320","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T18:13:27Z","timestamp":1748888007000},"source":"Crossref","is-referenced-by-count":5,"title":["Switching From Dual to Monotherapy for Gonorrhea is Associated With a Halving of Gonococcal Resistance to Azithromycin\u2014A Modelling Study of MSM in Belgium"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7565-1359","authenticated-orcid":false,"given":"Achilleas","family":"Tsoumanis","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine Antwerp , Antwerp ,","place":["Belgium"]},{"name":"Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp , Antwerp ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8010-1351","authenticated-orcid":false,"given":"Christophe","family":"Van Dijck","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine Antwerp , Antwerp ,","place":["Belgium"]},{"name":"Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University , Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1881-0637","authenticated-orcid":false,"given":"Niel","family":"Hens","sequence":"additional","affiliation":[{"name":"Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp , Antwerp ,","place":["Belgium"]},{"name":"Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University , Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2557-8998","authenticated-orcid":false,"given":"Chris","family":"Kenyon","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine Antwerp , Antwerp ,","place":["Belgium"]},{"name":"Department of Medicine, Division of Infectious Diseases and HIV Medicine, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"2025062505220165000_ofaf320-B1","volume-title":"In: ECDC. 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