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Failure Rate of Cefixime for N. gonorrhoeae Infection Explored

Increased risk of clinical treatment failure with minimum inhibitory concentration of ≥0.12 µg/mL

TUESDAY, Jan. 8 (HealthDay News) -- For Neisseria gonorrhoeae (N. gonorrhoeae) infections, the rate of clinical treatment failure with cefixime is 6.77 percent, and is associated with minimum inhibitory concentrations (MICs) of 0.12 µg/mL or more, according to a study published in the Jan. 9 issue of the Journal of the American Medical Association.

Noting that increased MICs to cefixime have been associated with reports of clinical failure, Vanessa G. Allen, M.D., M.P.H., from Public Health Ontario in Toronto, and colleagues conducted a retrospective cohort study involving 291 N. gonorrhoeae culture-positive individuals at a single sexual health clinic to examine risk of cefixime-linked clinical treatment failure.

Of the 133 individuals (97 percent male) who returned for test of cure, the researchers found that 13 were culture positive and nine had experienced cefixime failure, involving urethral, pharyngeal, and rectal sites, for an overall clinical treatment failure rate of 6.77 percent. There was a 25 percent rate of clinical treatment failure with a cefixime MIC of 0.12 µg/mL or greater, compared with a 1.9 percent rate of infections with a cefixime MIC of less than 0.12 µg/mL (relative risk, 13.13).

"In summary, we identified a relatively high rate of clinical failure in a clinic in Toronto after treatment of N gonorrhoeae infections with cefixime, which was associated with elevated MICs," the authors write.

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