Neisseria gonorrhoeae With Reduced Susceptibility to Azithromycin—San Diego County, California, 2009

A single 2g dose of azithromycin effectively treats genitourinary infections caused by susceptible Neisseria gonorrhoea and has been used to treat uncomplicated gonorrhea in persons with cephalosporin allergy. However, azithromycin is not recommended as monotherapy because of concern over the emergence of resistance. Instead, a 1 g dose of azithromycin is recommended as a component of dual therapy for gonorrhea, in conjunction with a cephalosporin. During August-October 2009, five of 55 (9.1%) N. gononhoea isolates obtained from men with symptomatic urethritis tested at San Diego County's main municipal sexually transmitted disease clinic had high azithromycin minimal inhibitory concentrations: three with 8 μg/mL and two with 16 μg/mL. Katz et al summarize the laboratory and epidemiologic findings associated with this reduced susceptibility to azithromycin. A CDC editorial note is included.