Johnson said she also was concerned that some doctors might be unaware that up to 30 percent of gonorrhea cases are resistant to the antibiotic ciprofloxacin - cipro - and that "treatment failures" related to use of that drug could be contributing to the increase.
The Philadelphia health advisory recommends that doctors use the alternative antibiotics ceftriaxone or cefixime.
The infection, caused by the bacteria Neisseria gonorrhoeae, can be spread through oral, anal, and/or vaginal sex.
In men, the symptoms of genital gonorrhea are pain during urination and puslike discharge. Women can experience vaginal discharge and discomfort if they have symptoms, but most gonorrhea infections in women are without symptoms.
Thomas Fekete, chief of the division of infectious diseases at the Temple University School of Medicine, said the estimated 10 percent of men and significantly larger number of women who do not know they have the infection, and therefore do not seek treatment, can contribute to its spread.
Major risk factors for contracting gonorrhea and other sexually transmitted diseases are: being under 25, a history of previous STDs, having multiple sexual partners, not using condoms consistently, and a history of drug use or sex work.
The city's advisory said patients being treated for gonorrhea should be simultaneously treated for chlamydia infection unless they have tested negative for it.
Gonorrhea is relatively benign in most cases, although some women develop a more serious infection (pelvic inflammatory disease) and the bacteria can be transmitted to babies during childbirth. A gonorrhea infection suggests that someone is engaged in activities that puts him or her at higher risk of more serious STDs, including HIV, Fekete said.
Contact staff writer Josh Goldstein at 215-854-4733 or jgoldstein@phillynews.com.
