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Related Experiment Video

Updated: Nov 1, 2025

Quantitative Examination of Antibiotic Susceptibility of Neisseria gonorrhoeae Aggregates Using ATP-utilization Commercial Assays and Live/Dead Staining
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Developing a model to predict individualised treatment for gonorrhoea: a modelling study.

Lucy Findlater1, Hamish Mohammed2, Maya Gobin3

  • 1National Infection Service, Public Health England, Bristol, UK lucy.findlater@phe.gov.uk.

BMJ Open
|June 26, 2021
PubMed
Summary

A new model predicts individualised gonorrhoea treatment, enabling use of older antibiotics and saving 97% of last-line ceftriaxone doses. This approach reduces reliance on ceftriaxone while minimizing risks of delayed effective treatment for gonorrhoea.

Keywords:
epidemiologygenitourinary medicinepublic healthsexual medicine

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Area of Science:

  • Antimicrobial resistance
  • Infectious disease epidemiology
  • Public health

Background:

  • Neisseria gonorrhoeae is a leading cause of sexually transmitted infections.
  • Rising antimicrobial resistance threatens effective gonorrhoea treatment.
  • Ceftriaxone is a last-line antibiotic, and its overuse necessitates alternative strategies.

Purpose of the Study:

  • To develop a predictive tool for individualised gonorrhoea treatment.
  • To facilitate the use of previously recommended antibiotics.
  • To reduce the reliance on ceftriaxone, a critical last-line agent.

Main Methods:

  • A modelling study using data from England and Wales (2015-2017).
  • An Excel model was developed incorporating demographic, behavioural, and clinical characteristics.
  • Model parameters were derived from the Gonococcal Resistance to Antimicrobials Surveillance Programme data.

Main Results:

  • Simulated model use indicated 88% of individuals could receive cefixime and 10% azithromycin.
  • This strategy could save 97% of ceftriaxone doses.
  • Only 1% of individuals experienced delayed effective treatment.

Conclusions:

  • Demographic and behavioural factors alone were insufficient to reliably predict susceptibility to older antibiotics like ciprofloxacin or penicillin.
  • While cefixime showed low resistance, widespread substitution for ceftriaxone risks re-emergence of resistance.
  • Targeted use of azithromycin in specific subgroups is possible, but population-level monotherapy risks resistance; further research into predicting resistance to legacy antibiotics is warranted.