{"doi":"10.1093/cid/ciaa596","title":"Resistance-Guided Treatment of Gonorrhea: A Prospective Clinical Study","abstract":"BACKGROUND: Novel treatment strategies to slow the continued emergence and spread of antimicrobial resistance in Neisseria gonorrhoeae are urgently needed. A molecular assay that predicts in vitro ciprofloxacin susceptibility is now available but has not been systematically studied in human infections. METHODS: Using a genotypic polymerase chain reaction assay to determine the status of the N. gonorrhoeae gyrase subunit A serine 91 codon, we conducted a multisite prospective clinical study of the efficacy of a single oral dose of ciprofloxacin 500 mg in patients with culture-positive gonorrhea. Follow-up specimens for culture were collected to determine microbiological cure 5-10 days post-treatment. RESULTS: Of the 106 subjects possessing culture-positive infections with wild-type gyrA serine N. gonorrhoeae genotype, the efficacy of single-dose oral ciprofloxacin treatment in the per-protocol population was 100% (95% 1-sided confidence interval, 97.5-100%). CONCLUSIONS: Resistance-guided treatment of N. gonorrhoeae infections with single-dose oral ciprofloxacin was highly efficacious. The widespread introduction and scale-up of gyrA serine 91 genotyping in N. gonorrhoeae infections could have substantial medical and public health benefits in settings where the majority of gonococcal infections are ciprofloxacin susceptible. CLINICAL TRIALS REGISTRATION: NCT02961751.","journal":"Clinical Infectious Diseases","year":2020,"id":61582,"datarank":2.16039626924905,"base_score":4.04305126783455,"endowment":4.04305126783455,"self_citation_contribution":0.6064576901751826,"citation_network_contribution":1.5539385790738678,"self_endowment_contribution":0.6064576901751826,"citer_contribution":1.5539385790738678,"corpus_percentile":null,"corpus_rank":null,"citation_count":56,"citer_count":45,"citers_with_citation_signal":29,"citers_with_endowment":29,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9662,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02961751"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":325518,"name":"Claire Bristow","orcid":"0000-0002-0680-1218","position":1,"is_corresponding":false},{"id":316703,"name":"Olusegun O. Soge","orcid":"0000-0002-8504-2319","position":2,"is_corresponding":false},{"id":327412,"name":"Akbar Shahkolahi","orcid":null,"position":3,"is_corresponding":false},{"id":327413,"name":"Toni Waymer","orcid":null,"position":4,"is_corresponding":false},{"id":325519,"name":"Robert Bolan","orcid":"0000-0002-6686-1052","position":5,"is_corresponding":false},{"id":325520,"name":"Susan Philip","orcid":"0000-0002-2325-1916","position":6,"is_corresponding":false},{"id":327414,"name":"Lenore Asbel","orcid":null,"position":7,"is_corresponding":false},{"id":301167,"name":"Stephanie N. Taylor","orcid":"0000-0002-9144-4277","position":8,"is_corresponding":false},{"id":305155,"name":"Leandro Mena","orcid":"0000-0001-8994-6457","position":9,"is_corresponding":false},{"id":325521,"name":"Deborah Goldstein","orcid":"0000-0003-1858-3905","position":10,"is_corresponding":false},{"id":280636,"name":"Jonathan Powell","orcid":"0000-0002-8306-5162","position":11,"is_corresponding":false},{"id":327415,"name":"Michael R. Wierzbicki","orcid":null,"position":12,"is_corresponding":false},{"id":327416,"name":"Sheldon Morris","orcid":null,"position":13,"is_corresponding":false},{"id":250389,"name":"Jeffrey D. Klausner","orcid":"0000-0002-6922-7364","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-18T21:09:47.114172Z","pmid":"32766725","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}