Management of Antibiotic-Resistant

Because man is the only natural host of the species Neisseria gonorrhoeae, the ability of the gonococcus to thrive in a hostile antibiotic world serves as testimony both to the genetic principles of natural selection and to the unwillingness of its human host to limit sexual contacts to long-term mutually monogamous relation-ships. From 1945 to 1954, the first decade that penicillin was used to treat gonorrhea, antimicrobial resistance and treatment failures were extremely rare. Even the smallest doses of penicillin, tetracycline, or chloram-phenicol eradicated the helpless gonococcus, and a movement by ecologists of the day to place N gonor-rhoeae on a potentially endangered species list would not have been unjustified. However, during the next 15 years the gonococcus began to reveal its remarkable genetic resiliency. The proportion of isolates requiring more than 0.05 units of penicillin per mL for inhibi-tion increased from 0.67 % before 1955 to 65 % i