The US Centers for Disease Control and Prevention (CDC) says that gonorrhea, one of the nation’s most common sexually transmitted disease (STD) is now so drug resistant that few treatment options remain.
Yesterday the CDC announced it no longer recommends a group of commonly used antibiotics known as fluoroquinolones (ciprofloxacin, ofloxacin, and levofloxacin) as a treatment for gonorrhea in the United States.
New research shows that fluoroquinolone-resistant gonorrhea is now widespread among American heterosexuals and men who have sex with men. It has gone beyond the 5 per cent threshold in heterosexuals where a drug can no longer be recommended as a treatment. The threshold had already been crossed in earlier years for men who have sex with men.
The new evidence to support the decision comes from the CDC’s Gonococcal Isolate Surveillance Project (GISP) which covers 26 US cities.
The new GISP data shows that among heterosexual men, the percentage of fluoroquinolone-resistant Neisseria gonorrhoeae (QRNG) cases went up 11-fold between 2001 and 2006. In 2001 it was 0.6 per cent, and in early 2006 it was 6.7 per cent.
The treatment options that now remain are limited to one group of antibiotics only — the cephalosporins.
Public health officials are calling for research in this area to be speeded up to increase the treatment options. They are also calling for more effort to keep an eye on emerging drug resistance, especially to the cephalosporins.
“We are running out of options to treat this serious disease.”
And Dr John Douglas, director of the CDC’s Division of STD Prevention said that “New treatment recommendations are critical if we are to continue to see progress in controlling gonorrhea”. He added that:
“We cannot afford to lose ground against a disease that continues to affect roughly 700,000 Americans each year.”
Although the national rate of gonorrhea infections has steadily declined from 1975 to 1997, it has stayed flat since then. Nearly 340,000 cases were reported nationwide in 2005, but experts believe this only shows half the picture since many cases go unreported.
In terms of reported cases, gonorrhea is the second most common infectious disease in the US after chlamydia.
Symptoms can be so mild that people don’t know they have the disease, and pass it on to others without realizing it. Sexually active teenagers, young adults and African-Americans carry the highest rates of infection.
However, gonorrhea makes people more susceptible to HIV. In women it can cause inflammation of the pelvis and lead to infertility, and in men it causes a painful testicular condition called epididymitis which can also lead to infertility if not treated.
The CDC is urging state and local health departments to monitor gonorrhea treatment failures for possible emerging resistance, particularly to cephalosporin.
It is also working with the World Health Organization to strengthen international efforts to monitor cephalosporin resistance and invest more in research and development for new treatments.
Symptoms of gonorrhea
According to the CDC, the symptoms of gonorrhea are:
In men — many men have no symptoms. Some appear between 2 and 30 days of infection and include a burning feeling when urinating, or a white, yellow, or green discharge from the penis. Some men get painful or swollen testicles.
In women — symptoms are often mild, but most women have none, or mistake them for something else like a bladder or vaginal infection. They include a burning feeling when urinating, increased vaginal discharge, or vaginal bleeding between periods.
In both men and women — rectal infection can have no symptoms or result in discharge, anal itching, soreness, bleeding, or painful bowel movements. Infection in the throat can cause a sore throat but usually there are no symptoms.
Written by: Catharine Paddock
Writer: Medical News Today