Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2020/12/stewardship-resistance-scan-dec-17-2020
Stewardship / Resistance Scan for Dec 17, 2020
European antimicrobial resistance plan; Gonorrhea treatment guidelines
Filed Under:
Gonorrhea; Antimicrobial Stewardship
EU highlights progress on antimicrobial resistance action plan
The European Commission this week published its latest annual progress report on implementation of the European One Health Action Plan against Antimicrobial Resistance (AMR).
Among the highlights noted in the fifth progress report is the recent adoption of the European Union (EU) Farm to Fork Strategy, which aims to reduce EU sales of antibiotics for farmed animals and aquaculture by 50% by 2030, place AMR on the agenda of the G20 nations, implement a strategic approach to addressing pharmaceuticals in the environment, and adopt new EU legislation for AMR monitoring in bacteria from farm animals and food.
The report also highlights several agreements in 2020 between the EU and Asian countries to incorporate EU standards and measures for tackling AMR in trade agreements.
The three main pillars of the action plan, which was adopted in 2017, are to make the EU a best practice region, boost research, development, and innovation, and shape the global AMR agenda.
Dec 14 progress report
CDC updates treatment guidelines for uncomplicated gonorrhea
Citing rising resistance to azithromycin and the importance of antibiotic stewardship, the Centers for Disease Control and Prevention (CDC) is removing azithromycin from its recommended treatment regimen for uncomplicated gonorrhea.
Under new guidelines published today in Morbidity and Mortality Weekly Report (MMWR), the CDC is now recommending a single 500-milligram (mg) intramuscular shot of ceftriaxone for uncomplicated urogenital, anorectal, and pharyngeal gonorrhea. The previous guidelines recommended an intramuscular shot of 250 mg of ceftriaxone and an oral dose of azithromycin for uncomplicated infections caused by Neisseria gonorrhoeae.
The CDC recommended adding azithromycin to the regimen in 2010 to prevent ceftriaxone resistance and treat possible coinfection with Chlamydia trachomatis, and the combination therapy has been the only recommended regimen for uncomplicated gonorrhea since then.
The decision was made based on a review of literature and susceptibility data collected by the Gonococcal Isolate Surveillance Project, which showed that the national percentage of N gonorrhoeae isolates with reduced susceptibility to azithromycin increased more than sevenfold over 5 years (from 0.6% in 2013 to 4.6% in 2018). The percentage of isolates with reduced susceptibility to ceftriaxone remained steady over that period.
In addition, CDC staff were also concerned about the efficacy of azithromycin in treating chlamydial infections and studies showing increased presence of macrolide resistance genes in communities receiving mass administration of azithromycin.
"CDC recommends ceftriaxone monotherapy for treatment because N. gonorrhoeae remains highly susceptible to ceftriaxone, azithromycin resistance is increasing, and prudent use of antimicrobial agents supports limiting their use," the CDC concluded. "Continuing to monitor for emergence of ceftriaxone resistance through surveillance and health care providers' reporting of treatment failures will be essential to ensuring continued efficacy of recommended regimens."
In place of azithromycin, the guidelines recommend the addition of doxycycline if chlamydial infection has not been ruled out.
Dec 17 MMWR updated gonorrhea treatment guidelines
Stewardship / Resistance Scan for Dec 17, 2020
European antimicrobial resistance plan; Gonorrhea treatment guidelines
Filed Under:
Gonorrhea; Antimicrobial Stewardship
EU highlights progress on antimicrobial resistance action plan
The European Commission this week published its latest annual progress report on implementation of the European One Health Action Plan against Antimicrobial Resistance (AMR).
Among the highlights noted in the fifth progress report is the recent adoption of the European Union (EU) Farm to Fork Strategy, which aims to reduce EU sales of antibiotics for farmed animals and aquaculture by 50% by 2030, place AMR on the agenda of the G20 nations, implement a strategic approach to addressing pharmaceuticals in the environment, and adopt new EU legislation for AMR monitoring in bacteria from farm animals and food.
The report also highlights several agreements in 2020 between the EU and Asian countries to incorporate EU standards and measures for tackling AMR in trade agreements.
The three main pillars of the action plan, which was adopted in 2017, are to make the EU a best practice region, boost research, development, and innovation, and shape the global AMR agenda.
Dec 14 progress report
CDC updates treatment guidelines for uncomplicated gonorrhea
Citing rising resistance to azithromycin and the importance of antibiotic stewardship, the Centers for Disease Control and Prevention (CDC) is removing azithromycin from its recommended treatment regimen for uncomplicated gonorrhea.
Under new guidelines published today in Morbidity and Mortality Weekly Report (MMWR), the CDC is now recommending a single 500-milligram (mg) intramuscular shot of ceftriaxone for uncomplicated urogenital, anorectal, and pharyngeal gonorrhea. The previous guidelines recommended an intramuscular shot of 250 mg of ceftriaxone and an oral dose of azithromycin for uncomplicated infections caused by Neisseria gonorrhoeae.
The CDC recommended adding azithromycin to the regimen in 2010 to prevent ceftriaxone resistance and treat possible coinfection with Chlamydia trachomatis, and the combination therapy has been the only recommended regimen for uncomplicated gonorrhea since then.
The decision was made based on a review of literature and susceptibility data collected by the Gonococcal Isolate Surveillance Project, which showed that the national percentage of N gonorrhoeae isolates with reduced susceptibility to azithromycin increased more than sevenfold over 5 years (from 0.6% in 2013 to 4.6% in 2018). The percentage of isolates with reduced susceptibility to ceftriaxone remained steady over that period.
In addition, CDC staff were also concerned about the efficacy of azithromycin in treating chlamydial infections and studies showing increased presence of macrolide resistance genes in communities receiving mass administration of azithromycin.
"CDC recommends ceftriaxone monotherapy for treatment because N. gonorrhoeae remains highly susceptible to ceftriaxone, azithromycin resistance is increasing, and prudent use of antimicrobial agents supports limiting their use," the CDC concluded. "Continuing to monitor for emergence of ceftriaxone resistance through surveillance and health care providers' reporting of treatment failures will be essential to ensuring continued efficacy of recommended regimens."
In place of azithromycin, the guidelines recommend the addition of doxycycline if chlamydial infection has not been ruled out.
Dec 17 MMWR updated gonorrhea treatment guidelines