The Gonococcal Resistance to Antimicrobial Surveillance Programme (GRASP) funded by the Department and run by the Health Protection Agency, monitors gonococcal antimicrobial resistance at a number of sentinel sites in England and Wales. The percentages of gonorrhoea isolates from genito-urinary medicine (GUM) clinic patients submitted to GRASP in England and Wales between 2002 and 2006 which had confirmed resistance to penicillin, tetracycline and ciprofloxacin (a fluoroquinolone) are contained in the following table:
Percentage Antimicrobial 2002 2003 2004 2005 2006 Penicillin (MIC> = l mg/l) 9.8 9.7 11.4 17.9 9.5 Tetracycline (MIC> = 2 mg/l) 44.8 38.2 44.4 48 36.9 Ciprofloxacin (MIC> = l mg/l) 9.8 9.1 14.0 21.7 26.5 Notes: 1. MIC means minimum inhibitory concentration and is defined as the lowest concentration of an antimicrobial that will inhibit the visible growth of a micro-organism after overnight incubation. The MICs shown for the specific antimicrobials define the cut-off for resistance to these antimicrobials. 2. Due to variations in the retrieval and confirmation of isolates submitted in different years, the data on resistance prevalence are statistically weighted. This is done to avoid resistance estimates being under representative of sites that have a low retrieval rate and over representative of sites that have a high retrieval rate. Source: GRASP from specimens collected at genito-urinary medicine clinics.
Data from GRASP provide the evidence-base for treatment guidelines in the management of gonorrhoea. In 2002, this led to prescribing policy being updated to recommend that gonorrhoea should be treated with third generation cephalosporins, ceftriaxone or cefixime. Further information is contained in the GRASP annual report (year 2006 collection) which has been placed in the Library. No specific representations have been received by the Department on this issue.