{"doi":"10.1101/2025.07.01.25330638","title":"Comparing Strategies to Introduce Two New Antibiotics for Gonorrhea: A Modeling Study","abstract":"Introduction: is an urgent public health threat. The anticipated approval of two new antimicrobials for gonorrhea prompts the need for evidence-based rollout strategies that minimize drug resistance. Methods: We used a stochastic compartmental model of men who have sex with men (MSM) in the United States (U.S.) to compare two main strategies-equal allocation and sequential drug deployment-for two new and one existing drug and measured the time for each drug to reach a resistance prevalence threshold of 5%. We conducted broad analyses assessing the sensitivity of our results to wide variation in parameters governing the baseline behavior of the model and drug resistance evolution and fitness. Results: Compared to the equal allocation strategy, the sequential strategy had reached the resistance prevalence threshold i) for each drug individually in at least as many simulations; ii) for all three drugs in at least as many simulations; and iii) for at least as many drugs on average. After 10 years, no equal allocation strategy simulations had met the 5% resistance prevalence threshold for any of the drugs, whereas 99.6% of sequential simulations had for the first drug, of which 3.5% had also met the threshold for the second drug. The sequential strategy was worse for nearly every reasonable combination of model parameters. Conclusion: In a model of U.S. MSM, the equal allocation strategy for introducing new drugs for gonorrhea matched or outperformed the strategy of sequential introduction in terms of resistance prevalence.","journal":"medRxiv","year":2025,"id":558392,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9494,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1177209,"name":"Kirstin Roster","orcid":"0000-0003-3468-2014","position":1,"is_corresponding":false},{"id":1278918,"name":"David Helekal","orcid":"0000-0002-9319-7097","position":2,"is_corresponding":false},{"id":628891,"name":"Éva Rumpler","orcid":"0000-0003-2223-2681","position":3,"is_corresponding":false},{"id":41032,"name":"Yonatan H. Grad","orcid":"0000-0001-5646-1314","position":4,"is_corresponding":false},{"id":339641,"name":"Madeleine Kline","orcid":"0000-0003-1974-9276","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:55:25.969263Z","pmid":"40630587","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":[]}