'Gentamicin 240 mg plus azithromycin 2 g vs. ceftriaxone 500 mg plus azithromycin 2 g for treatment of rectal and pharyngeal gonorrhoea' - Author's reply
Abstrakt
We are grateful to Dr Sfeir for the insightful comments on our paper. We completely agree that a major limitation with Neisseria gonorrhoeae nucleic acid amplification tests (NAATs) is the lack of complete antimicrobial resistance (AMR) data, which only gonococcal culture can offer.
However, in studies focusing on examination of rectal and pharyngeal specimens (as in our study), a gonococcal NAAT for diagnosis is essential due to the exceedingly low sensitivity using culture:: i.e., ideally both NAAT and culture should be used for all specimens, but this is not always cost-effective or feasible. This strongly emphasizes the importance of developing appropriate rapid molecular assays to predict gonococcal AMR, which ideally could detect N. gonorrhoeae and multiple AMR determinants, and could be used at the point of care.
Such assays could be used for diagnosis of gonorrhoea, to inform individualized treatment (sparing the last line of empirical treatment), and for AMR surveillance.