Not so long ago, gonorrhea was a common and easily treatable sexually transmitted disease. It was simply a matter of picking up the right antibiotics. However, the occurrence of gonorrhea cases that do not – or hardly – respond to antibiotic treatment is increasing in frequency. Since the disease is in many cases asymptomatic most people still seem to think it is nothing more than inconvenient. However if left untreated (or not treated adequately) gonorrhea can lead to more serious problems including pelvic inflammatory disease, infertility and complications in pregnant woman and infants.
Many different antibiotic-resistant gonorrhea strains are seen around the world nowadays. Varying from year to year, population to population. Some scientists see a spark of hope in that, eliminating the use of gonorrhea antibiotics that are becoming ineffective on a local scale, strains that are resistant to those drugs will decrease in prevalence so that the drugs will become useful once again.
Drug-resistant gonorrhea: URGENT
It is estimated by the Center for Disease Control and Prevention that around 30% of the (at least) 800.000 U.S. cases of gonorrhea involves a multi drug resistant strain. This resulted in the URGENT threat ranking of Neisseria gonorrhea in 2013. N. gonorrhea is showing resistance to antibiotics usually used to treat it. These drugs include: oral and injectable cephalosporins, azithromycin and tetracycline
In the United States Gonorrhea is among the most commonly notified infections. The CDC recently even updated its treatment guidelines to slow the emergence of drug resistance. CDC now recommends an antibiotic cocktail instead. (ceftriaxone plus either azithromycin or doxycycline).
Cephalosporin-resistant N. gonorrhoeae is often also resistant to other classes of antibiotics. As a result, empiric treatment is likely to fail in these cases. If cephalosporin-resistant N. gonorrhoeae becomes more widespread, the public health impact will be large. Additional cases of pelvic inflammatory disease, infertility, epididymitis and HIV infections are expected. (note: HIV is transmitted more readily when a person is co-infected with gonorrhea.)The estimated direct increase in medical costs are $235 million in the US alone.
Gonorrhea is a global problem, and requires a global approach. Rapid detection and effective treatment of patients and their partners could slow the spread of resistance. Only use a treatment that is tested to be effective against the infectious stain. (testing before treatment!)
In a few years, gonorrhea treatment will cease to be a simple process completely. If antibiotics are continued to be given without prior testing the effectiveness of the chosen treatment kicking an infection may require course after course of antibiotics, basically using patients as testtubes. Your best option then – the same as it is now – avoid getting infected in the first place.
Reference and Credits: Antibiotic Resistance Threats in the United States 2013, Centers for Disease Control and Prevention. Sept. 16, 2013. (incl. image)
Scientist in the field? Please read: http://lumibyte.eu/colonybehavior-explorer/
Antibiotics No Longer Recommended For Gonorrhea Treatment due to Resistance
Sulfonamides – Over a short 9 year period, 30 percent of gonorrhea strains became resistant to treatment with sulfonamides. Sulfonamides were replaced by penicillin in the mid-1940s.
Penicillin – Although initially very effective, required penicillin doses for gonorrhea treatment climbed significantly over time. Stopped being used as a routine treatment in the 1980s.
Tetracycline – In the 1980s, tetracycline also ceased being a first-line treatment option due to the spread of resistant gonorrhea strains.
Fluoroquinolones (ciprofloxacin, ofloxacin and levofloxacin) – In 2007, the Center for Disease Control and Prevention changed the guidelines for gonorrhea treatment again and removed the single-dose fluoroquinolones from the recommended list. Fluoroquinolone-resistant gonorrhea strains have been identified around the world.
Oral Cephalosporins (ceftriaxone, cefixime) – The percentage of gonorrhea strains resistant to oral ceftriaxone went up more than ten-fold in many areas before being removed from the recommended treatment list. Cefixime is no longer recommended for gonorrhea treatment at all, Only exceptation is in cases where ceftriaxone can not be used.