Antibiotic Resistance Making Gonorrhea Harder, Sometimes Impossible, to Treat
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Antibiotic Resistance Making Gonorrhea Harder, Sometimes Impossible, to Treat

Older and cheaper antibiotics are no longer effective in treating the disease

July 10, 2017

The World Health Organization (WHO) has announced that growing antibiotic resistance has made the sexually-transmitted infection gonorrhea more difficult, and in some cases impossible, to treat.

Evolving Bacteria

"The bacteria that cause gonorrhoea [sic] are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them," said Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO.

Data from 77 countries has revealed that there is widespread resistance to older and cheaper antibiotics, and there are some countries where the disease is now unaffected by all known antibiotics.

Seventy-Eight Million Infections

"These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea [sic] is actually more common," adds Dr Wi.

It is estimated that 78 million people are infected with gonorrhea every year. Complications of the infection affect women disproportionately more than men, causing problems including pelvic inflammatory disease, ectopic pregnancy and infertility, and a higher risk of HIV.

Many factors contribute to this increase in antibiotic resistance, including decreasing usage of condoms, more urbanization and travel, poor rates of detection of the infection, and either inadequate or failed treatment.

Few New Drugs in Development

There are only three new potential drug treatments in development at this time, all of which are in various phases of clinical trial.

There is little incentive for commercial pharmaceutical companies to invest in developing new antibiotics. Patients take treatments only for short periods of time, unlike medications for chronic diseases. And the drugs become less effective as resistance develops, so there has to be a constant replenishment of new ones.

The Best Treatment: Prevention

It is possible to prevent gonorrhea by engaging in safer sexual behavior and practices, especially the consistent and correct use of condoms. It is crucial to provide information, education, and communication to promote and enable safer practices, improve people's abilities to recognize the symptoms of sexually-transmitted infections, and make it more likely that they will seek care.

To date, there are no affordable, fast, point-of-care diagnostic tests for gonorrhea. Many infected people have no symptoms, leading them to go undiagnosed and untreated. When they do experience symptoms, doctors often assume that gonorrhea is the cause and prescribe antibiotics, even though it may be another kind of infection altogether. Such inappropriate usage of the drugs increases the development of antibiotic resistance.

"To control gonorrhoea [sic], we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures," said Dr. Marc Sprenger, who directs antimicrobial resistance at WHO. "Specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests – ideally, ones that can predict which antibiotics will work on that particular infection – and longer term, a vaccine to prevent gonorrhoea [sic]."