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Deep learning-enabled discovery of antibiotics effective against <i>Neisseria gonorrhoeae</i>.

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Updated: Jan 13, 2026

Quantitative Examination of Antibiotic Susceptibility of Neisseria gonorrhoeae Aggregates Using ATP-utilization Commercial Assays and Live/Dead Staining
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Comparing Strategies to Introduce Two New Antibiotics for Gonorrhea: A Modeling Study.

Madeleine C Kline1,2,3, Kirstin Oliveira Roster1,2, David Helekal1,2

  • 1Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 8, 2026
PubMed
Summary

Introducing new gonorrhea drugs requires careful planning to combat rising antimicrobial resistance. An equal allocation strategy for new drugs proved more effective than sequential deployment in a US men who have sex with men (MSM) model, minimizing resistance.

Keywords:
antimicrobial resistancetransmission-dynamic modelzoliflodacin; gepotidacin

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Area of Science:

  • Epidemiology
  • Mathematical Modeling
  • Public Health

Background:

  • Neisseria gonorrhoeae drug resistance is a critical global health concern.
  • The upcoming release of new antimicrobials necessitates strategies to prevent further resistance.
  • Effective rollout plans are crucial for gonorrhea treatment and public health preservation.

Purpose of the Study:

  • To compare the effectiveness of equal drug allocation versus sequential drug deployment for new gonorrhea treatments.
  • To model the emergence of drug resistance in Neisseria gonorrhoeae within a US men who have sex with men (MSM) population.
  • To determine which strategy minimizes the time to reach a 5% resistance prevalence threshold.

Main Methods:

  • A stochastic compartmental model simulating the US MSM population was utilized.
  • Two primary drug introduction strategies were compared: equal allocation and sequential deployment.
  • Model sensitivity was analyzed across various parameters influencing behavior and resistance evolution.

Main Results:

  • The sequential strategy reached the 5% resistance prevalence threshold faster than equal allocation for individual drugs and all drugs combined.
  • After 10 years, 99.6% of sequential simulations exceeded the threshold for the first drug, compared to 0% for equal allocation.
  • However, the sequential strategy performed worse across most tested model parameter combinations.

Conclusions:

  • The equal allocation strategy for introducing new gonorrhea drugs is superior to sequential introduction in minimizing resistance prevalence within the studied US MSM population.
  • This finding supports evidence-based rollout strategies to preserve antimicrobial efficacy.
  • The study highlights the importance of strategic drug introduction in combating antimicrobial resistance.