High prevalence of high-level ciprofloxacin resistance in Neisseria gonorrhoeae in Tel Aviv, Israel: correlation with response to therapy.

A survey of the drug susceptibilities of gonococcal isolates from 100 consecutive patients attending clinics in the Tel Aviv area of Israel during the period from February to September 2000 has shown a 61% rate of ciprofloxacin resistance (MICs, > or =1 microg/ml); 51 isolates were highly resistant (MICs, > or =4 microg/ml). Ciprofloxacin-resistant strains were more prevalent among isolates with chromosomally mediated resistance to penicillin and tetracycline. Therapeutic failures with ciprofloxacin correlated with MICs of > or =1 mg/ml (P < 0.01). The high rate of ciprofloxacin resistance coinciding with a sharp rise in the incidence of gonorrhea precludes the use of fluoroquinolone drugs for the empirical treatment of gonococcal infections acquired in Israel.