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Antibiotic resistance has become so pervasive among strains of Neisseria gonorrheae that, as of 2007, cephalosporins were the only CDC-recommended agents for treating U.S. patients with gonorrhea. Now, even cephalosporins are no longer completely reliable agents in some parts of the world, leaving no good options for gonorrhea patients in whom treatment fails or in those with true cephalosporin allergies.
Researchers evaluated two combination regimens for treating uncomplicated urogenital or pharyngeal gonorrhea in almost 600 patients (most men). Patients were randomized to receive 2 g of oral azithromycin plus either 240 mg of gentamicin intramuscularly or 320 mg of oral gemifloxacin. The microbiologic rationale for these regimens: Azithrom…