Azithromycin

The N. gonorrhoeae reference strains were obtained from the WHO reference strain panel for global quality assurance and quality control of gonococcal AMR testing^{21 (link),41 (link)}. The rest of N. gonorrhoeae strains used were clinical isolates obtained from the CDC (Supplementary Table 1). The commensal vaginal bacterial strains were obtained from the Biodefense and Emerging Infections Research Resources Repository (BEI Resources) (Supplementary Table 2). All chemical compounds used in this study were obtained commercially from chemical vendors: auranofin (Chem-Impex International, Wood Dale, IL), sodium aurothiomalate, tetracycline and ciprofloxacin (Sigma-Aldrich, St. Louis, MO), aurothioglucose (USP reference standard Rockville, MD), ceftriaxone and cefixime (Acros Organics, NJ), and azithromycin (TCI America, Portland, OR).
Difco lactobacilli MRS broth, Brucella base broth and chocolate II agar (GC II Agar with hemoglobin and IsoVitaleX) were purchased from Becton, Dickinson and Company (Cockeysville, MD). Yeast extract and dextrose (Fisher Bioreagents, Fairlawn, NJ), proteose-peptone, nicotinamide adenine dinucleotide (NAD) and agarose (Sigma-Aldrich, St. Louis, MO), hematin solution, Tween 80, and pyridoxal (Chem-Impex International, Wood Dale, IL) were purchased from chemical vendors.

N. gonorrhoeae strains (Table S1) used in the study were clinical isolates obtained from the CDC and the American Type Culture Collection (ATCC) (Manassas, VA, USA). Drugs used in this study were purchased from chemical vendors: AZM (Alfa Aesar, Tewksbury, MA, USA), EZM and tetracycline (Sigma-Aldrich, Saint Louis, MO, USA), azithromycin and ceftriaxone (TCI America, Portland, OR, USA). Media and reagents were purchased commercially: brucella broth, GC medium base, IsoVitaleX, bovine haemoglobin, and chocolate II agar plates (Becton, Dickinson and Company, Cockeysville, MD, USA), yeast extract and dextrose (Fisher Bioreagents, Fairlawn, NJ, USA), protease peptone (Oxoid, Lenexa, KS, USA), haematin, pyridoxal, and nicotinamide adenine dinucleotide (NAD) (Chem-Impex International, Wood Dale, IL, USA), corn starch (Spectrum Chemical MFG, Gardena, CA, USA), monobasic potassium phosphate and dibasic potassium phosphate (Macron chemicals, Centre Valley, PA, USA), and sodium chloride (Fisher Scientific, Fail Lawn, NJ, USA), and phosphate-buffered saline (PBS) (Corning, Manassas, VA, USA).

MTCs 1–15 were obtained as reported earlier²² (link), whereas acetazolamide AAZ (as standard CAI) and buffers were of >99% purity, commercially available from Sigma-Aldrich (Milan, Italy). Antibiotics were purchased commercially: Azithromycin (TCI America, OR, USA), linezolid (Chem-Impex, IL, USA), and vacomycin (GoldBio, MO, USA).