Susceptibility of Neisseria gonorrhoeae to Quinolones and Azithromycin: ItsImplication in the Treatment of Pharyngeal Infection

Neisseria gonorrhoeae infections are the second most common bacterial sexually transmitted infections (STI) in our area [1-3]. Resistance to this microorganism is currently considered a global threat by the World Health Organization (WHO). Current Spanish guidelines recommend a dual therapy with extended-spectrum cephalosporines (such as cefotaxime, ceftriaxone, cefuroxime or cefixime) and azithromycin (AZT) [4]. Dual therapy has shown synergy in-vitro and in-vivo and is effective against Chlamydia trachomatis. In pharyngeal infections cephalosporins have shown to be less effective than quinolones; thus, UK guideline recommend ciprofloxacin (CIP) in pharyngeal infection if the isolate is known to be quinolone susceptible. On the other hand, European and German guidelines recommend quinolones as an alternative treatment in pharyngeal infections if the isolated strain is susceptible to these compounds and there are indications against using ceftriaxone [5].