Update : Information on the Availability in Canada of Cefixime (Suprax) for the treatment of Gonorrhea

November 2003

Recently, Aventis Pharma confirmed that they have secured a new supplier for cefixime (Suprax), a recommended treatment for N. gonorrhoea in Canada as indicated in the 1998 edition of the Canadian STD Guidelines, in Canada. Wyeth-Ayerst, the company who previously manufactured cefixime for distribution in Canada, discontinued production of this medication in November 2002. For additional information on the discontinuation, please go to: http://www.phac-aspc.gc.ca/std-mts/cefixime1202/index-eng.php

New dosages and formats of this medication are now available. Tablets are now packaged in blister packs of seven and ten 400mg tabs instead of bottles of 50 tablets. Suprax® suspension is now available in 50mL volumes at a concentration of 100mg per 5mL.

Alternative treatments do exist, although they are less appealing. Ceftriaxone requires injection and may be considered less convenient than cefixime which is administered orally. Fluoroquinolones are also recommended for the treatment of gonorrhea, however in some areas of Canada quinolone-resistent strains of gonorrhea have arisen, limiting their use.

From 1997 to 2002, the reported rate of gonorrhea has increased by over 50% with the majority of the increase occurring in males. This increase may be attributed to:

• The introduction of a new non-invasive testing methodology, which may encourage more people to be tested

• The relaxation of safer sex practices. The risk of transmission of gonorrhea may increase through incorrect and inconsistent condom use and a higher number of sexual partners.

References

CDC. Notice to Readers: Discontinuation of Cefixime Tablets - United States. MMWR 2002; 51(46):1052.

Sarwal S. et al. Increasing incidence of ciprofloxacin-resistant Neisseria gonorrhoeae infection in Canada. CMAJ 168: 872-3, 2003. http://www.cmaj.ca/cgi/content/full/168/7/872

Hansen L. et al. Gonorrhoea resurgence in Canada. Int J STD & AIDS 2003;14(11):727-731.
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