The World Health Organization (WHO) warned this Friday that gonorrhea is becoming much harder to treat around the world. According to the WHO, 77 countries have submitted data that shows that antibiotic resistance is making gonorrhea, a common sexually transmitted disease, sometimes impossible to treat.
The Centers for Disease Control and Prevention describes gonorrhea as an STD that can infect both men and women. The disease can cause infection in the genitals, rectum, and sometimes in the throat.
The CDC notes that gonorrhea is very common, especially among young people aged 15 to 24 years. The disease is spread by having vaginal, anal, or oral sex with someone infected with gonorrhea; and pregnant women can pass it on to their child during childbirth.
Bacteria that cause gonorrhea are particularly smart and become resistant to antibiotics
The WHO believes the worldwide spread of the disease has been caused by oral sex and decline in condom use. And as it spreads, it is getting increasingly harder for doctors to treat it.
“The bacteria that cause gonorrhea are particularly smart,” said Dr. Teodora Wi, Medical Officer in Human Reproduction at WHO, according to a statement published in WHO’s website. “Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them.”
The health organization reported a widespread resistance to older and cheaper antibiotics around the world. They noted that some countries -especially high-income ones, where surveillance is better- are finding cases of the infection that are untreatable by all known antibiotics.
Wi said that those cases might just be the tip of the iceberg since systems to diagnose and report untreatable infections are scarce in lower-income countries where gonorrhea is actually more common.
Each year, over 78 million people are infected with gonorrhea, according to the WHO. Complications of the disease affect women more than men, and side effects can include pelvic inflammatory disease, ectopic pregnancy, and infertility, as well as an increased risk of HIV.
The WHO listed decreasing condom use, increased urbanization and travel, poor infection detection rates, and inadequate or failed treatment as causes for the increase in gonorrhea cases.
ESCs are the only available treatment to treat gonorrhea currently
Any person who is sexually active is at risk for contracting gonorrhea, according to the CDC. The CDC recommends being in a long-term monogamous relationship with a partner who has been tested and doesn’t have any STDs and using latex condoms “the right way” every time you have sex, as ways to lower your chances of getting gonorrhea.
The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP) is a WHO organization tasked with monitoring trends in antibiotic-resistance gonorrhea. The WHO GASP data from 2009 through 2014 showed a widespread resistance to ciprofloxacin (97 percent), increasing resistance to azithromycin (81 percent), and the emergence of resistance to the current treatment, the extended-spectrum cephalosporins (ESCs) oral cefixime or injectable ceftriaxone (66 percent)
The WHO reported that currently, in most countries, ESCs are the only antibiotics that remain effective for treating gonorrhea, but now resistance to cefixime and ceftriaxone has been reported in over 50 countries.
The organization issued updated global treatment recommendations for gonorrhea last year advising doctors to give only two antibiotics: ceftriaxone and azithromycin. According to the organization, there are only three new candidate drugs in various stages of clinical development.
However, the development of new antibiotics doesn’t appear to be attractive for commercial pharmaceutical companies. Treatments are needed only for short periods of time-unlike drugs for chronic diseases- and they become less efficient as time goes by and resistance develops, which means that the supply of new antibiotics constantly needs to be replenished.
‘Any new treatment should be accessible to everyone who needs it’
The WHO launched the Global Antibiotic and Development Partnership (GARDP), a non-profit research and development organization, to address that issue. The non-profit’s mission is to develop new drugs and promote appropriate use, so that they remain effective for as long as possible while ensuring access to everyone at the same time. One of GARDP’s priorities is the development of new antibiotics to treat gonorrhea.
“To address the pressing need for new treatments for gonorrhea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline,” said Dr. Manina Balasegaram, GARDP director, according to WHO. “Any new treatment developed should be accessible to everyone who needs it, while ensuring it’s used appropriately, so that drug resistance is slowed as much as possible.”
Currently, there aren’t any affordable, rapid, point-of-care diagnostic tests for gonorrhea, said the WHO. Many people who get the disease don’t show any symptoms, so they go undiagnosed and untreated. Furthermore, when patients do show symptoms, such as discharge from the vagina or urethra, doctors usually assume it is gonorrhea and prescribe antibiotics, even though patients may be suffering from another kind of infection.
Dr. Marc Sprenger, the Director of Antimicrobial Resistance at the WHO, noted that to control gonorrhea, they need new tools and systems for better prevention, treatment, early diagnosis, and more complete tracking and reporting of new infections.
“Specially, we need new antibiotics, as well as a 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 gonorrhea,” added Sprenger.
Source: World Health Organization