Gonorrhea Close to Gaining Superbug Status

(March 30) -- Unless medical experts devise a new way to treat it, gonorrhea -- the world's second most common sexually transmitted infection, after chlamydia -- will soon become a drug-resistant superbug.

"This is a very clever bacteria. If this problem isn't addressed, there is a real possibility that gonorrhea will become a very difficult infection to treat," Catherine Ison, a British gonorrhea specialist, told Reuters.

The bacterial infection is most common in southern Asia and Africa. Left untreated, it can cause pelvic inflammatory disease and lead to ectopic pregnancies and infertility among women.

Right now, gonorrhea is treated with a single antibiotic dose, of either cefixime or ceftriaxone. But some strains of the illness are becoming resistant to both drugs, meaning treatment could become increasingly difficult without innovations.

Superbugs are defined as bacteria that resist all available courses of antibiotic treatment.

The first instances of antibiotic resistance to cefixime and ceftriaxone have already occurred in Japan, where health authorities are fighting back by raising the treatment dosage. Reports of resistance in Hong Kong, Asia and Australia are also being investigated.

Higher doses can only thwart gonorrhea for so long: The bacteria will soon resist higher drug volumes. Preventive measures, especially condoms, are being touted as the best way to mitigate gonorrhea's spread, by stopping the illness before it even starts.

Doctors could also combine both gonorrhea drugs for a double dose of treatment. That's the tactic used to treat tuberculosis.

"There are few new drugs available. So using more than one at the same time is probably what should happen in the first instance," Ison said.

But prescribing double-dose treatments, or multiple doses of a single drug, can be risky: Patients are less likely to come back for a second round, meaning an illness like gonorrhea would continue to spread -- and do so more quickly.

Cefixime and ceftriaxone are only the latest in a long line of drugs used to treat gonorrhea. In the 1970s, the bacteria became resistant to penicillin. Since then, it's fought off dozens of antibiotics, including common varieties like cipro and rocephin. That's led to ongoing changes in federal treatment recommendations.

Of course, gonorrhea is far from the only illness to develop dangerous antibiotic resistance. Increasingly hardy mutations of urinary tract infections, pneumonia and HIV are all prompting ongoing calls for renewed efforts at developing more sustainable drug interventions.

Gonorrhea is a major health problem in the United States, but its spread is even more troubling for developing countries. When resources to cope with untreatable sexually transmitted infections are scarce, consequences -- infertility, chronic infections and vulnerability to HIV -- are heightened.

One common bacterial STI, syphilis, remains treatable with penicillin.

But health officials could soon have a second STI superbug on their hands. Chlamydia, once thought to be resistant to mutations that would thwart treatment, isn't so easily treated after all. Research published by the American Society for Microbiology concluded that chlamydia's response to antibiotics is the same as other STIs, but relapse rates among patients is so high -- 5 to 20 percent -- that it's difficult to ascertain whether the bacteria resists antibiotics or patients just keep getting infected.