Azithromycin-resistant N. gonorrhoeae isolates have been reported from Europe, Latin America and the Caribbean, East Asia, and other parts of the world.4,6???8 Although GISP has not observed clear azithromycin susceptibility trends during the past several years,25 a cluster of gonococcal isolates with azithromycin resistance was identified in San Diego in 2009 among men who have sex with men,5 and