{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:53:35Z","timestamp":1787068415090,"version":"build-2736575974"},"reference-count":18,"publisher":"BMJ","issue":"6","funder":[{"name":"Amsterdam Public Health Service Research and Development Fund","award":["75722378"],"award-info":[{"award-number":["75722378"]}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["848015001"],"award-info":[{"award-number":["848015001"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,12,18]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Objectives<\/jats:title>\n \n The New AntiBiotic treatment Options for uncomplicated GOnorrhoea trial compared the efficacy of gentamicin, ertapenem and fosfomycin with ceftriaxone. Ertapenem was non-inferior to ceftriaxone for treating\n Neisseria gonorrhoeae<\/jats:italic>\n , but participants receiving ertapenem commonly reported having diarrhoea. We assessed diarrhoea trajectories, estimated the probability of remaining with diarrhoea over time and identified determinants of diarrhoea.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Participants were randomly assigned (1:1:1:1) to receive intramuscular 5\u2009mg\/kg gentamicin (maximum 400\u2009mg), intramuscular 1000\u2009mg ertapenem, oral 6\u2009g fosfomycin or intramuscular 500\u2009mg ceftriaxone (control group). Following antibiotic treatment, participants self-reported adverse events, including diarrhoea, in a paper diary until 30 days after treatment. In this secondary analysis, we assessed the frequency of diarrhoea in each study arm. Kaplan-Meier methods were used to estimate the probability of remaining with diarrhoea over time in each study arm. Determinants of diarrhoea in the ertapenem arm were assessed using relative risk regression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 343 participants randomised, 2\/102 (2.0%) in the gentamicin arm, 49\/97 (50.5%) in the ertapenem arm, 32\/37 (86.5%) in the fosfomycin arm and 11\/103 (10.7%) in the ceftriaxone arm reported diarrhoea. Median duration of diarrhoea varied between 1 and 2\u2009days across arms. In the ertapenem arm, only having an anal\n N. gonorrhoeae<\/jats:italic>\n and\/or anal\n Chlamydia trachomatis<\/jats:italic>\n infection (prevalence ratio=2.29, 95% CI 1.04 to 5.02) was associated with increased diarrhoea risk.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Ertapenem was associated with high frequency of diarrhoea, which was mostly short-lived. Continued evaluation of the tolerability of ertapenem could help increase acceptability of this potential second-line treatment against\n N. gonorrhoeae<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT03294395<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056735","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T18:20:51Z","timestamp":1768587651000},"page":"394-397","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Diarrhoea as a frequent adverse event after intramuscular ertapenem treatment for uncomplicated\n Neisseria gonorrhoeae<\/i>\n : a secondary analysis from the NABOGO trial"],"prefix":"10.1136","volume":"102","clinical-trial-number":[{"clinical-trial-number":"nct03294395","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03294395","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1526-7977","authenticated-orcid":false,"given":"Buhari","family":"Teker","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands"},{"name":"Department of Dermatology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4903-7002","authenticated-orcid":false,"given":"Maarten","family":"Schim van der Loeff","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands"},{"name":"Department of Internal Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AI&I), Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health research institute (APH), Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Boyd","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AI&I), Amsterdam, The Netherlands"},{"name":"Stichting hiv monitoring, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Mathot","sequence":"additional","affiliation":[{"name":"Department of Hospital Pharmacy & Clinical Pharmacology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3967-550X","authenticated-orcid":false,"given":"Alje","family":"van Dam","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands"},{"name":"Medical Microbiology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands"},{"name":"Department of Dermatology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AI&I), Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health research institute (APH), Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9538-1501","authenticated-orcid":false,"given":"Vita Willemijn","family":"Jongen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AI&I), Amsterdam, The Netherlands"},{"name":"Stichting hiv monitoring, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"2026081808050877000_102.6.394.1","unstructured":"World Health Organisation (WHO) . Gonorrhoea (neisseria gonorrhoeae infection) 2024. 2024. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/gonorrhoea-(neisseria-gonorrhoeae-infection)"},{"key":"2026081808050877000_102.6.394.2","first-page":"1903","article-title":"Emergence of Extensively Drug-Resistant Neisseria gonorrhoeae","volume":"30","author":"Camelena","year":"2023","journal-title":"Emerg Infect Dis"},{"key":"2026081808050877000_102.6.394.3","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaf071"},{"key":"2026081808050877000_102.6.394.4","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1093\/jac\/dkaf109","article-title":"The continuing evolution of antibiotic resistance in Neisseria gonorrhoeae: past, present and future threats to effective treatment","volume":"80","author":"Fifer","year":"2025","journal-title":"J Antimicrob Chemother"},{"key":"2026081808050877000_102.6.394.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00625-3"},{"key":"2026081808050877000_102.6.394.6","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1016\/S0140-6736(25)00628-2","article-title":"Oral gepotidacin for the treatment of uncomplicated urogenital gonorrhoea (EAGLE-1): a phase 3 randomised, open-label, non-inferiority, multicentre study","volume":"405","author":"Ross","year":"2025","journal-title":"The Lancet"},{"key":"2026081808050877000_102.6.394.7","doi-asserted-by":"crossref","unstructured":"Wickham H , Sievert C . Ggplot2: Elegant graphics for data analysis . springer New York, 2009.","DOI":"10.1007\/978-0-387-98141-3"},{"key":"2026081808050877000_102.6.394.8","first-page":"ii75","article-title":"Safety and tolerability of ertapenem","volume":"53 Suppl 2","author":"Teppler","year":"2004","journal-title":"J Antimicrob Chemother"},{"key":"2026081808050877000_102.6.394.9","doi-asserted-by":"publisher","DOI":"10.1086\/339543"},{"key":"2026081808050877000_102.6.394.10","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1046\/j.1532-5415.2003.51507.x","article-title":"Ertapenem therapy for community-acquired pneumonia in the elderly","volume":"51","author":"Woods","year":"2003","journal-title":"J Am Geriatr Soc"},{"key":"2026081808050877000_102.6.394.11","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.5.1732-1735.2003"},{"key":"2026081808050877000_102.6.394.12","unstructured":"National Center for Biotechnology Information . PubChem compound summary for CID 150610, ertapenem bethesda (MD): national library of medicine (US), national center for biotechnology information. 2004. Available: https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/Ertapenem"},{"key":"2026081808050877000_102.6.394.13","doi-asserted-by":"crossref","DOI":"10.1186\/s13073-016-0294-z","article-title":"The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation","volume":"8","author":"Langdon","year":"2016","journal-title":"Genome Med"},{"key":"2026081808050877000_102.6.394.14","first-page":"1855","article-title":"Ertapenem: a review of its use in the management of bacterial infections","volume":"63","author":"Curran","year":"2003","journal-title":"Drugs (Abingdon Engl)"},{"key":"2026081808050877000_102.6.394.15","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.10.3765-3772.2004"},{"key":"2026081808050877000_102.6.394.16","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-199512030-00004"},{"key":"2026081808050877000_102.6.394.17","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7005a1"},{"key":"2026081808050877000_102.6.394.18","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac061"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056735","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:08:18Z","timestamp":1787065698000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":18,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,8,18]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/sextrans-2025-056735"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056735","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]}}}