Gonorrhea caused by fluoroquinolone resistant gonococci

We describe a case of 4-fluoroquinolone resistant gonorrhoea where treatment failed on several occasions and where there may have been reinfections. Since 1995 peroral single dose 4-fluoroquinolones have been recommended as first preference treatment for uncomplicated gonorrhoea in Norway. However, Neisseria gonorrhoeae has a high ability to create resistance, and the emergence of 4-fluoroquinolone resistant strains is causing worldwide concern. An increasing number of 4-fluoroquinolone resistant gonococcal strains have also been observed in Norway, and the number of failures in the recommended treatment regime are increasing. It is proposed that 4-fluoroquinolone resistant strains be reported nationally.