A recent analysis by the Centers for Disease Control and Prevention (CDC) indicates that the bacteria responsible for gonorrhea may be developing resistance to one of the current treatments for the infection — the antibiotic azithromycin.
Gonorrhea is a sexually transmitted infection caused by Neisseria gonorrhoeae bacteria. The bacteria are found mainly in discharge from the penis and in vaginal fluid and are readily transferred from person to person during unprotected sexual activity.
Since the bacteria die after a short time outside the body, infection cannot be transferred through kissing or casual contact, eg, sharing a bathroom, swimming pools.
The difficulty in preventing the spread of infection arises from the fact that in many cases (one in ten infected men and half of infected women) no symptoms are apparent.
Despite the lack of initial symptoms, gonorrhea infection can lead to serious health problems and infertility if it spreads to other reproductive organs.
There are an estimated 78 to 88 million cases of gonorrhea occur each year. It is treated with dual antibiotic therapy, injected ceftriaxaone and oral azithromycin. There is currently a high treatment success rate, but data reported recently have raised concerns that this may change.
A recent analysis of data and isolates from the Gonococcal Isolate Surveillance Project (GISP) indicates that the susceptibility of gonorrhea infection to the drug azithromycin declined from 2013 to 2014.
Antibiotic resistance in Neisseria gonorrhoeae, and in many other bacteria, is a growing concern globally...it is essential that we continue to monitor closely for the development of antibiotic resistance as well as the effectiveness of antibiotic therapy and conduct research to develop new drugs and make our current drugs more effective.”
Dr Carlos del Rio of the Antibiotic Resistance Center at Emory University.
Since these are the first data to suggest declining antibiotic susceptibility of the gonorrhea-causing bacteria it cannot be concluded that azithromycin will become ineffective in the treatment of gonorrhoea.
However, the findings are alarming since gonorrhea has already developed resistance to other antibiotics previously used to treat gonorrhea.
Azithromycin forms the basis of all current treatments for gonorrhea so, if the bacteria do become resistant to it, gonorrhea could become an untreatable infection. This is particularly concerning since the rate of gonorrhea infections continues to rise.
Increased public awareness and regular screening to prevent the spread of infection remain key in the battle against gonorrhea. In addition continued surveillance of resistance patterns and the development of new antibiotics are required to ensure we continue to have effective strategies to manage gonorrhea morbidity.