TY - JOUR
T1 - Effect on the resistome of dual vs monotherapy for the treatment of Neisseria gonorrhoeae: results from a randomized controlled trial (ResistAZM Trial)
AU - Thibaut, Vanbaelen
AU - Eric, Florence
AU - Christophe, Van Dijck
AU - Achilleas, Tsoumanis
AU - Laumen, Jolein Gyonne Elise
AU - Sheeba, Manoharan-Basil Santhini
AU - Saïd, Abdellati
AU - De Block, Tessa
AU - Irith, De Baetselier
AU - Dorien, Van den Bossche
AU - Yven, Van Herrewege
AU - Anke, Rotsaert
AU - Chris, Kenyon
N1 - FTX; DOAJ; (CC BY NC ND)
PY - 2023
Y1 - 2023
N2 - BACKGROUND: No randomized controlled trial (RCT) has compared the impact on the resistome of ceftriaxone (CRO) plus azithromycin (AZM) vs CRO for the treatment of Neisseria gonorrhoea (NG).METHODS: This was an open-label, single-center, RCT comparing the effect on the resistome of CRO plus AZM vs CRO for the treatment of NG. Men who have sex with men (MSM) with genital, anorectal, or pharyngeal NG infection were randomized into the CRO/AZM and CRO arms. Oral rinse and anorectal samples were taken for culture and resistome profiling at 2 visits (baseline and day 14). The primary outcome was the ratio of mean macrolide resistance determinants in anorectal samples from day 14 between arms.RESULTS: Twenty individuals were randomized into the CRO/AZM arm and 22 into the CRO arm. We found no significant difference in the mean macrolide resistance determinants in the day 14 anorectal samples between arms (ratio, 1.05; 95% CI, 0.55-1.83; P = .102). The prevalence of baseline macrolide resistance was high (CRO/AZM arm = 95.00%; CRO arm = 90.91%).CONCLUSIONS: We could not demonstrate a significant effect of dual CRO/AZM therapy on the resistome compared with CRO alone, likely due to a high baseline resistance to AZM. Interventions to prevent the emergence of antimicrobial resistance in MSM are needed.
AB - BACKGROUND: No randomized controlled trial (RCT) has compared the impact on the resistome of ceftriaxone (CRO) plus azithromycin (AZM) vs CRO for the treatment of Neisseria gonorrhoea (NG).METHODS: This was an open-label, single-center, RCT comparing the effect on the resistome of CRO plus AZM vs CRO for the treatment of NG. Men who have sex with men (MSM) with genital, anorectal, or pharyngeal NG infection were randomized into the CRO/AZM and CRO arms. Oral rinse and anorectal samples were taken for culture and resistome profiling at 2 visits (baseline and day 14). The primary outcome was the ratio of mean macrolide resistance determinants in anorectal samples from day 14 between arms.RESULTS: Twenty individuals were randomized into the CRO/AZM arm and 22 into the CRO arm. We found no significant difference in the mean macrolide resistance determinants in the day 14 anorectal samples between arms (ratio, 1.05; 95% CI, 0.55-1.83; P = .102). The prevalence of baseline macrolide resistance was high (CRO/AZM arm = 95.00%; CRO arm = 90.91%).CONCLUSIONS: We could not demonstrate a significant effect of dual CRO/AZM therapy on the resistome compared with CRO alone, likely due to a high baseline resistance to AZM. Interventions to prevent the emergence of antimicrobial resistance in MSM are needed.
U2 - 10.1093/ofid/ofad462
DO - 10.1093/ofid/ofad462
M3 - A1: Web of Science-article
C2 - 37854109
SN - 2328-8957
VL - 10
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 10
M1 - ofad462
ER -