High-Level Quinolone Resistance in Neisseria gonorrhoeae: A Report of Two Cases

Background and Objectives: Fluoroquinolones are widely used oral agents for treating Neisseria gonorrhoeae. Resistance to these agents is sporadic and usually at a low level. Two instances of high-dose ciprofloxacin regimens failing in the treatment of gonococcal infection, caused by strains with high-level quinolone resistance, are reported. Study Design: This is a case report Conclusion: High-level resistance to quinolone antibiotics resulting hi treatment failure was observed in two distinct gonococcal isolates from patients infected in the Philippines (ciprofloxacin; minimal inhibitory contribution = 16 mg/1). Continued monitoring of the quinolone sensitivity of Neisseria gonorrhoeae is appropriate and prudent.