To the Editor: The emergence of extended-spectrum cephalosporin resistance in Neisseria gonorrhoeae infections in North America and worldwide is worrisome, as is the current US response to that problem.1 Authorities call for adherence to treatment recommendations, use of test of cure, risk-reduction counseling, increased condom use, clinician vigilance for treatment failure, and novel antimicrobial development.2 Even though these measures are reasonable, none has been shown to reduce the population-level ecological effects of drug-resistant organisms.
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