Antibiotic resistance among sexually transmitted infections: perspectives from clinical practice

We present two cases of men who have sex with men (MSM) in care at the Infectious Diseases Unit, San Raffaele Hospital, Milan diagnosed with multidrug-resistant (MDR) STIs. Both presented with complaints of urethral discharge and were engaged in receptive/insertive sexual intercourse with >10 partners monthly, with seldom condom use. The first case is an injecting-drug user with history of hepatitis B and C virus coinfection diagnosed in 2013 with ceftriaxone-resistant Neisseria gonorrhoeae (NG) proctitis, and ciprofloxacin-resistant and azithromycin-resistant Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT) urethritis, concurrent with primary HIV infection. NG proctitis was treated with benzylpenicillin (2.4 million units/week for 3 weeks), given reduced susceptibility, and with azithromycin (2 g); UU/CT urethritis was treated with doxycycline, given resistance to azithromycin. The second case is an MSM with HIV/HBV coinfection diagnosed in 2018 with UU urethritis resistant to tetracyclines, macrolides and quinolones, which was treated with moxifloxacin, although resistant...
Source: Sexually Transmitted Infections - Category: Sexual Medicine Authors: Tags: PostScript Source Type: research