{"id":10241,"date":"2025-03-01T14:03:15","date_gmt":"2025-03-01T19:03:15","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan273\/"},"modified":"2025-03-02T00:50:55","modified_gmt":"2025-03-02T05:50:55","slug":"dhan273","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan273\/","title":{"rendered":"php\/alerts\/dhan273 ~  Division of Public Health &#8212; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan273.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->273 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->August 17, 2012 8:13 am <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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On August 10,\n\n\n  2012 the Centers for Disease Control and Prevention (CDC) published its weekly <a class=\"anchors_link\" href=\"http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6131a3.htm?s_cid=mm6131a3_e#box\">MMWR August 10, 2012 \/ Vol. 61<\/a>,\n\n\n  \u201cUpdate to CDC\u2019s Sexually Transmitted Diseases Treatment Guidelines, 2010\u201d which stated oral cephalosporins are no\n\n\n  longer a recommended treatment for gonococcal infections.\n\n\n<\/p>\n\n\n<p>\n\n\n  Data from CDC\u2019s Gonococcal Isolate Surveillance Project (GISP), described laboratory evidence of declining cefixime susceptibility\n\n\n  among urethral N. gonorrhea isolates collected in the United States during 2006\u20132011.\n\n\n<\/p><br>\n\n\n<table class=\"table table-condensed table-hover\">\n\n\n  <tbody>\n\n\n    <tr>\n\n\n      <th scope=\"col\">\n\n\n        Updated Recommended Treatment Regimens for Gonococcal Infections<br>\n\n\n        <br>\n\n\n      <\/th>\n\n\n    <\/tr>\n\n\n    <tr>\n\n\n      <td>\n\n\n        <p>\n\n\n          <strong>Uncomplicated gonococcal infections of the cervix, urethra, and rectum<\/strong>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <strong><em>Recommended regimen<\/em><\/strong>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Ceftriaxone 250 mg in a single intramuscular dose\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <em>PLUS<\/em>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Azithromycin 1 g orally in a single dose\n\n\n        <\/p>\n\n\n        <p>\n\n\n          \u00a0or doxycycline 100 mg orally twice daily for 7 days*\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <strong><em>Alternative regimens<\/em><\/strong>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <span style=\"text-decoration: underline\">If ceftriaxone is not available<\/span>:\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Cefixime 400 mg in a single oral dose\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <em>PLUS<\/em>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Azithromycin 1 g orally in a single dose\n\n\n        <\/p>\n\n\n        <p>\n\n\n          \u00a0or doxycycline 100 mg orally twice daily for 7 days*\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <em>PLUS<\/em>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Test-of-cure in 1 week (can only be tested by gonorrhea culture, not nucleic acid amplification test {NAAT})\n\n\n        <\/p>\n\n\n        <p>\n\n\n          If the patient has severe cephalosporin allergy:\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Azithromycin 2 g in a single oral dose\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <em>PLUS<\/em>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Test-of-cure in 1 week (can only be tested by gonorrhea culture, not nucleic acid amplification test {NAAT})\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <strong>Uncomplicated gonococcal infections of the pharynx<\/strong>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <strong><em>Recommended regimen<\/em><\/strong>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Ceftriaxone 250 mg in a single intramuscular dose\n\n\n        <\/p>\n\n\n        <p>\n\n\n          <em>PLUS<\/em>\n\n\n        <\/p>\n\n\n        <p>\n\n\n          Azithromycin 1 g orally in a single dose\n\n\n        <\/p>\n\n\n        <p>\n\n\n          \u00a0or doxycycline 100 mg orally twice daily for 7 days*\n\n\n        <\/p>\n\n\n      <\/td>\n\n\n    <\/tr>\n\n\n  <\/tbody>\n\n\n<\/table>\n\n\n<p>\n\n\n  Health care providers need to be aware of the potential for future resistance and <span style=\"text-decoration: underline\">take these\n\n\n  important steps<\/span> to ensure successful treatment outcomes for their patients:\n\n\n<\/p>\n\n\n<ol>\n\n\n  <li>\n\n\n    <strong>Treat promptly:<\/strong> health-care providers should use dual-therapy, ceftriaxone and azithromycin for the treatment of\n\n\n    uncomplicated gonorrhea.\n\n\n  <\/li>\n\n\n  <li>\n\n\n    <strong>Culture: if<\/strong> a patient has suspected or documented treatment failure obtain an isolate to test for\n\n\n    susceptibility.\u00a0\n\n\n  <\/li>\n\n\n  <li>\n\n\n    <strong>Report suspected treatment failure:<\/strong> to the DPH Sexually Transmitted Disease Program by FAX at 302-857-5086.\n\n\n  <\/li>\n\n\n<\/ol>\n\n\n<p>\n\n\n  * Because of the high prevalence of tetracycline resistance among Gonococcal Isolate Surveillance Project isolates, particularly those\n\n\n  with elevated minimum inhibitory concentrations to cefixime, the use of azithromycin as the second antimicrobial is preferred.\n\n\n<\/p>\n\n\n<p>\n\n\n  For additional information about this or any other STDs or to report a case, call the DPH Sexually Transmitted Disease Program at\n\n\n  302-744-1050 or visit our <a href=\"\/dph\/dpc\/stds.html\">web page @\n\n\n  http:\/\/dhss.delaware.gov\/dph\/dpc\/stds.html<\/a>\n\n\n<\/p>\n\n\n<p>\n\n\n  ********************\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this message because you are a registered member of the Delaware Health Alert Network. If you are not a member and\n\n\n  would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\n\n\n<\/p><!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #273 August 17, 2012 8:13 am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10241","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10241","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10241"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10241\/revisions"}],"predecessor-version":[{"id":11417,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10241\/revisions\/11417"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10241"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}