Polite Dissent

I’m a bit puzzled by this Associated Press article on the new treatment recommendations for Gonorrhea.

I’m not surprised that drug-resistant Gonorrhea is on the rise, nor that the CDC now recommends cephalosporins as a first-line treatment agent — pretty much everyone knew this was coming.

What I am puzzled about is the second-half of this statement from the article:

The newly recommended class of antibiotics includes the generic drug ceftriaxone, also known under the brand name Rocephin, which must be injected and “works very well” although the drug is not commonly stocked in doctor’s offices, Douglas said.

[Emphasis mine. The Douglas the article refers to is Dr. John Douglas Jr., director of the CDC’s division of STD prevention.]

I’d be interested to know on what Dr. Douglas bases his statement (if it was indeed correctly attributed to him). It runs contrary to my experience and to the experiences of my colleagues.

While I don’t know for certain, I suspect the vast majority of STD patients are seen by their primary care physician, the ER, an urgent care clinic, or their OB/GYN. I have never known a primary care physicians office, emergency room, or urgent care that did not stock ceftriaxone; it is that common a medication. (I’m not entirely sure about OB/GYN offices, but a quick informal poll tells me that the local offices all carry ceftriaxone.)

I’m just wondering who is out of touch here, me or the CDC’s Director of the Division of STD Prevention? (Personally, I’m suspicious that it’s the third option: clumsy reporting from the AP. Wouldn’t be the first time. I e-mailed the CDC and asked for a clarification — we’ll see if I ever hear back).