We are running out of ways to treat gonorrhea, the World Health
Organization announced.
The U.N. health agency released new guidelines warning
doctors that it no longer recommends an entire class of antibiotics,
quinolones, because quinolone-resistant strains of the disease have emerged all
over the world.
Instead, the health agency recommends using cephalosporins,
another class of antibiotic. The new protocol replaces guidelines that had not
been changed since 2003.
According to the WHO, 78 million people are infected with gonorrhea
every year.
Worldwide, health officials are concerned that overuse of
antibiotics for other infections, such as urinary tract infections, will lead
to widespread, untreatable strains of gonorrhea. In 2011, a super-resistant
strain showed up in Japan.
"'Gonorrhea used to be
susceptible to penicillin, ampicillin, tetracycline and doxycycline — very
commonly used drugs,' said Jonathan Zenilman, who studies infectious diseases
at Johns Hopkins.
"But one by one, each of those antibiotics — and almost
every new one that has come along since — eventually stopped working. One
reason is that the bacterium that causes gonorrhea can mutate quickly to defend
itself, Zenilman said.
The WHO shift to the new class of antibiotics
will not fix that overall problem of bacterial creativity. In some countries,
strains of gonorrhea are already resistant to the newly recommended class of
drugs.
The U.S. Centers for Disease Control and Prevention warned back
in 2012 that one of two drugs in the class of antibiotics the WHO now
recommends, cephalosporins, was in danger of becoming useless to treat
gonorrhea, at least in the U.S, and recommended that doctors stop prescribing
it.
Since then, the CDC's recommended treatment for gonorrhea has
been a dual therapy, with the two antibiotics ceftriaxone and azithromycin, but
an analysis in July warned
that the bacteria could even become resistant to that combination.
As for when antibiotic options
will run out altogether, Teodora Wi of the WHO's Department of Reproductive
Health and Research tells the journal Science, "We
will have to have new drugs in 5 years, I think."
The U.S. government is spending
millions of dollars through the CDC and National Institutes of
Health to develop new antibiotics and combat resistance.
The WHO also revised its guidelines for treating two other
sexually transmitted infections, chlamydia and syphilis. Neither is facing
severe antibiotic resistance. Syphilis, for example, can be treated with a
single dose of penicillin, although there is a worldwide shortage of the drug.
Although all three sexually transmitted diseases affect both men
and women, they can have particularly devastating effects on women if they are
not treated. Gonorrhea can cause pelvic inflammatory disease and lead to
dangerous ectopic pregnancies. Syphilis can pass from a pregnant woman to her
fetus, and chlamydia can make it
difficult for a woman to get pregnant.
Source: npr.org
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