Drug-resistant gonorrhea is a major public health concern

In response to the growing crisis of drug-resistant sexually transmitted diseases (STDs), today two leading national public health organizations -- the National Coalition of STD Directors (NCSD) and the American Sexually Transmitted Diseases Association (ASTDA) -- called for increased funding for research and development of new drugs to fight STDs.

The called for increased funding was based on new treatment guidelines from the Centers for Disease Control and Prevention (CDC) stating that fluoroquinolones no longer be used as first-line treatment for gonorrhea among men who have sex with men (MSM). The new recommendations are based on preliminary data showing an increase in drug-resistant gonorrhea cases in the United States in 2003, especially among gay and bisexual men. Surveillance data from Massachusetts and New York City shows resistant gonorrhea rates eight times higher among MSM than among heterosexual men.

The increasing resistance to fluoroquinolones effectively eliminates an entire class of antibiotics and leaves only one class of drugs -- cephalosporins -- as the first-line therapy in the treatment of gonorrhea. There are currently no other major groups of antibiotics left to treat gonorrhea.

"Drug-resistant gonorrhea is a major public health concern," said Dr. Jonathan Zenilman, president of ASTDA and chief of the Infectious Diseases Division at Johns Hopkins Bayview Medical Center. "Every time a sexually transmitted disease becomes resistant to another drug, that's one less weapon in our arsenal. Right now we have only a handful of drugs that we can use to properly treat gonorrhea. Without proper treatment, gonorrhea infections can linger and can cause pelvic inflammatory disease, infertility, and can make infected persons more susceptible to other STDs, including HIV."

"The warning signs were there. First we started finding resistant gonorrhea in Hawaii. Then a few years ago, we found it here in California, which prompted a change in our treatment guidelines," said Dr. Gail Bolan, board chair of NCSD and chief of the STD Control Branch of the California Department of Health Services. "It was only a matter of time before resistant gonorrhea started showing up in the rest of the country. Yet even with those warnings, there has been no major increase in funding for research into new drugs to replace the ones we've lost. At some point -- possibly some point very soon -- we're going to find that we have nothing left to treat gonorrhea with. What will we do then?"

"Gonorrhea is just the beginning. Other sexually transmitted diseases are becoming resistant to the drugs we have available," said Theresa Raphael, executive director of NCSD. "We must find new drugs to treat these diseases, before the few we have are rendered completely useless. Finding new drugs means one thing: more money. The federal government needs to spend more money on research, more money on surveillance, and more money on treatment. Drug companies need to focus their attention on the rising tide of antibiotic-resistant sexually transmitted infections. The alternative is an epidemic left completely unchecked."

NCSD represents the directors of public health sexually transmitted disease prevention programs in states, large cities/counties and territories of the United States, and advocates for effective policies, strategies, and sufficient resources to fight the spread of sexually transmitted diseases.

ASTDA is an organization devoted to the control and study of sexually transmitted diseases. Its objectives are to support the control and ultimate eradication of STD; to support research in all aspects of STD, including medical, epidemiologic, laboratory, social and behavioral studies; to recognize outstanding contributions in STD control; and to disseminate authoritative information concerning STD.

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