The use of fluoroquinolones in gonorrhoea: the increasing problem of resistance

Expert Opin Pharmacother. 2004 Apr;5(4):829-54. doi: 10.1517/14656566.5.4.829.


The recent re-emergence of gonorrhoea in developed countries has been accompanied by the rise and spread of gonococcal resistance to the fluoroquinolones. In the 1980s fluoroquinolones were considered an important addition to the arsenal of agents used to treat gonorrhoea. They proved to be excellent drugs for this indication, including infections caused by penicillinase-producing and tetracycline-resistant strains of Neisseria gonorrhoeae. However, as gonococci have a well-recognised potential to develop resistance to antibiotics, the first reports of reduced susceptibility to fluoroquinolones appeared a few years after their introduction. Gonococcal resistance to fluoroquinolones is now well-established in the Far East, from where it has spread to Australia, Hawaii, California and Europe. In Africa and Latin America, gonococci continue to be susceptible to fluoroquinolones.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • DNA Gyrase / genetics
  • DNA Topoisomerase IV / genetics
  • Drug Resistance, Bacterial*
  • Female
  • Fluoroquinolones / therapeutic use*
  • Gonorrhea / drug therapy*
  • Gonorrhea / microbiology*
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae / drug effects
  • Neisseria gonorrhoeae / genetics


  • Fluoroquinolones
  • DNA Topoisomerase IV
  • DNA Gyrase