{"doi":"10.1093/cid/ciac682","title":"Prior Exposure to Azithromycin and Azithromycin Resistance Among Persons Diagnosed With <i>Neisseria gonorrhoeae</i> Infection at a Sexual Health Clinic: 2012–2019","abstract":"BACKGROUND: There is conflicting evidence on whether prior azithromycin (AZM) exposure is associated with reduced susceptibility to AZM (AZMRS) among persons infected with Neisseria gonorrhoeae (NG). METHODS: The study population included Public Health-Seattle and King County Sexual Health Clinic (SHC) patients with culture-positive NG infection at ≥1 anatomic site whose isolates were tested for AZM susceptibility in 2012-2019. We used multivariate logistic regression to examine the association of time since last AZM prescription from the SHC in ≤12 months with subsequent diagnosis with AZMRS NG (minimum inhibitory concentration [MIC], ≥2.0 µg/mL) and used linear regression to assess the association between the number of AZM prescriptions in ≤12 months and AZM MIC level, controlling for demographic, behavioral, and clinical characteristics. RESULTS: A total of 2155 unique patients had 2828 incident NG infections, 156 (6%) of which were caused by AZMRS NG. AZMRS NG was strongly associated with receipt of AZM from the SHC in the prior 29 days (adjusted odds ratio, 6.76; 95% confidence interval [CI], 1.76 to 25.90) but not with receipt of AZM in the prior 30-365 days. Log AZM MIC level was not associated with the number of AZM prescriptions within ≤12 months (adjusted correlation, 0.0004; 95% CI, -.04 to .037) but was associated with number of prescriptions within <30 days (adjusted coefficient, 0.56; 95% CI, .13 to .98). CONCLUSIONS: Recent individual-level AZM treatment is associated with subsequent AZMRS gonococcal infections. The long half-life and persistence of subtherapeutic levels of AZM may result in selection of resistant NG strains in persons with recent AZM use.","journal":"Clinical Infectious Diseases","year":2022,"id":281622,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9458,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":316703,"name":"Olusegun O. Soge","orcid":"0000-0002-8504-2319","position":1,"is_corresponding":false},{"id":316704,"name":"James P. Hughes","orcid":"0000-0001-5034-3157","position":2,"is_corresponding":false},{"id":932351,"name":"Anna Berzkalns","orcid":null,"position":3,"is_corresponding":false},{"id":677376,"name":"Christina Thibault","orcid":null,"position":4,"is_corresponding":false},{"id":397678,"name":"Roxanne P. Kerani","orcid":"0000-0002-4416-4280","position":5,"is_corresponding":false},{"id":490006,"name":"Christine M. Khosropour","orcid":"0000-0002-9743-0829","position":6,"is_corresponding":false},{"id":301166,"name":"Lisa E. Manhart","orcid":"0000-0002-4896-7654","position":7,"is_corresponding":false},{"id":311289,"name":"Matthew R. Golden","orcid":"0000-0001-7449-3774","position":8,"is_corresponding":false},{"id":444182,"name":"Lindley A. Barbee","orcid":"0000-0002-7189-5492","position":9,"is_corresponding":false},{"id":956845,"name":"Emily Rowlinson","orcid":"0000-0003-2436-1022","position":0,"is_corresponding":true}],"reference_count":42,"raw_metadata":null,"created_at":"2026-07-19T00:29:11.698554Z","pmid":"36001447","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":[]}