{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:46:52Z","timestamp":1783594012574,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T00:00:00Z","timestamp":1634256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of the Basque Country UPV\/EHU","award":["PA20\/03"],"award-info":[{"award-number":["PA20\/03"]}]},{"name":"University of the Basque Country UPV\/EHU","award":["GIU20\/048"],"award-info":[{"award-number":["GIU20\/048"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>The aim of this study was to apply molecular epidemiology, antimicrobial surveillance, and PK\/PD analysis to guide the antimicrobial treatment of gonococci infections in a region of the north of Spain. Antibiotic susceptibility testing was performed on all isolates (2017 to 2019, n = 202). A subset of 35 isolates intermediate or resistant to at least two antimicrobials were selected to search for resistance genes and genotyping through WGS. By Monte Carlo simulation, we estimated the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of the antimicrobials used to treat gonorrhea, both indicative of the probability of treatment success. In total, 2.0%, 6.4%, 5.4%, and 48.2% of the isolates were resistant to ceftriaxone, cefixime, azithromycin, and ciprofloxacin, respectively. Twenty sequence types were identified. Detected mutations were related to antibiotic resistance. PK\/PD analysis showed high probability of treatment success of the cephalosporins. In conclusion, multiple populations of N. gonorrhoeae were identified. We can confirm that ceftriaxone (even at the lowest dose: 250 mg) and oral cefixime are good candidates to treat gonorrhea. For patients allergic to cephalosporins, ciprofloxacin should be only used if the MIC is known and \u22640.125 mg\/L; this antimicrobial is not recommended for empirical treatment.<\/jats:p>","DOI":"10.3390\/pharmaceutics13101699","type":"journal-article","created":{"date-parts":[[2021,10,17]],"date-time":"2021-10-17T23:05:47Z","timestamp":1634511947000},"page":"1699","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Molecular Epidemiology, Antimicrobial Surveillance, and PK\/PD Analysis to Guide the Treatment of Neisseria gonorrhoeae Infections"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8129-4850","authenticated-orcid":false,"given":"Rodrigo","family":"Alonso","sequence":"first","affiliation":[{"name":"Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country UPV\/EHU, 01006 Vitoria-Gasteiz, Spain"},{"name":"Bioaraba Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy Group, 01009 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainara","family":"Rodr\u00edguez-Achaerandio","sequence":"additional","affiliation":[{"name":"Bioaraba Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy Group, 01009 Vitoria-Gasteiz, Spain"},{"name":"Microbiology Service, Araba University Hospital, Osakidetza Basque Health Service, 01009 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaia","family":"Aguirre-Qui\u00f1onero","sequence":"additional","affiliation":[{"name":"Bioaraba Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy Group, 01009 Vitoria-Gasteiz, Spain"},{"name":"Microbiology Service, Araba University Hospital, Osakidetza Basque Health Service, 01009 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aitor","family":"Artetxe","sequence":"additional","affiliation":[{"name":"Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country UPV\/EHU, 01006 Vitoria-Gasteiz, Spain"},{"name":"Bioaraba Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy Group, 01009 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8867-1487","authenticated-orcid":false,"given":"Ilargi","family":"Mart\u00ednez-Ballesteros","sequence":"additional","affiliation":[{"name":"Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country UPV\/EHU, 01006 Vitoria-Gasteiz, Spain"},{"name":"Bioaraba Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy Group, 01009 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3195-6385","authenticated-orcid":false,"given":"Alicia","family":"Rodr\u00edguez-Gasc\u00f3n","sequence":"additional","affiliation":[{"name":"Bioaraba Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy Group, 01009 Vitoria-Gasteiz, Spain"},{"name":"Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, University of the Basque Country UPV\/EHU, 01006 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3093-7078","authenticated-orcid":false,"given":"Javier","family":"Garaizar","sequence":"additional","affiliation":[{"name":"Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country UPV\/EHU, 01006 Vitoria-Gasteiz, Spain"},{"name":"Bioaraba Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy Group, 01009 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3836-9906","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Canut","sequence":"additional","affiliation":[{"name":"Bioaraba Microbiology, Infectious Disease, Antimicrobial Agents, and Gene Therapy Group, 01009 Vitoria-Gasteiz, Spain"},{"name":"Microbiology Service, Araba University Hospital, Osakidetza Basque Health Service, 01009 Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fasciana, T., Capra, G., Di Carlo, P., Cal\u00e0, C., Vella, M., Pistone, G., Colomba, C., and Giammanco, A. 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