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admin 22.08.2015

Six months after a warning was published in the medical journal The New England Journal of Medicine that gonorrhea was quickly becoming untreatable by the last two effective drugs, the CDC reports that one of those drugs no longer works. The bulletin, which was published on August 9th, states that there is a high enough percentage of resistance to the oral antibiotic cephalosporin cefixime that the CDC no longer recommends using it as a first-line regimen for the treatment of gonococcal infections.
The entire structure of the way that the USA controls sexually transmitted disease — single doses of drugs given in outpatient-clinic visits — is dependent on the effectiveness of the one remaining drug.
The fact that cetriaxone has to be used already complicates matters, because pills can be dispensed by any clinic worker whereas injections must be given by a licensed health professional.  If the resistance gets works and the remaining drug becomes unusable, which could happen, over the next seven years, gonorrhea incidence would increase four-fold to nearly 6 million additional cases, nearly 800 additional HIV infections, a quarter million cases of pelvic inflammatory disease in women, and cost over three-quarters of a billion dollars. Over the years, an article comes out that a disease, once easily treated with standard antibiotics, becomes no longer effective and a new standard for treatment is created. According to the new guidelines, it is telling doctors to hold off on a potent oral antibiotic, which is now being used to treat the infection.
According to the CDC, the dangers of gonorrhea range from being a major cause of infertility among women to increasing the risk of being infected with HIV, the virus that causes AIDS, and that they will spread it to their partners. Carlos del Rio, a physician on the board of directors for the Infectious Diseases Society of America, and an author of the new CDC treatment guidelines, talks about how gonorrhea has always been a “canary in the coal mine,” for doctors, because “it picks up resistance very easily.” As early as the 1930’s, the disease became resistant to the first antimicrobial drugs used against it. Today, antibiotic resistance has reached the point that doctors need to think very carefully about the drugs they prescribe for common conditions.
He does note that there is support from the infectious disease society for federal legislation that would provide drug makers with financial incentives if they create new antibiotics. With concern over incurable or fatal diseases like AIDS in today’s society, many do not realize how serious gonorrhea is when contracted.
The disease increases the chance of contracting a dangerous condition called ectopic pregnancy.


Another disease that can occur is called pelvic inflammatory disease that can lead to infertility.
Since antibiotics were first used for treatment of gonorrhea, the organism has progressively developed resistance to the sulfa drugs prescribed to treat it.
That just leaves one antibiotic to treat the disease, which is caused by the bacterium Neisseria gonorrhoeae. Physicians should now use a single dose of injectable cetriaxone, accompanied by some additional oral drugs.
Once cetriaxone becomes ineffective, gonorrhea will be treated by IV drugs, which is more expensive, complicated and slower. On Thursday, it appears to have happened again as federal health officials took steps to head off the emergence of a new gonorrhea “superbug” that’s resistant to standard antibiotics. The disease has finally become resistant to antibiotics except for one particular class and that could soon become ineffective, federal health officials warned.
The guidelines now dictate to doctors to use an injectable form because it appears that the gonorrhea bacteria seem less likely to develop resistance.
If this wasn’t bad enough, treatment for gonorrhea, which was easy to treat as recently as 2007, has become increasingly difficult.
During the 1940’s, doctors tried using one of the first known antibiotics, penicillin, to fight it. Judith O’ Donnell, head of infectious diseases at Penn Presbyterian Medical Center in Philadelphia, feels strongly about this and says some examples are sinus infections, urinary tract infections and ear infections. Susan Philip, director of STD prevention and control services at the San Francisco Department of Public Health, comments on the harsh reality for women who contract gonorrhea.


What happens is a fertilized egg will not plant in the uterus but the fallopian tubes instead. Gonorrhea can also harm newborn children in untreated mothers, although it rarely happens in developed countries such as the USA. She also adds the best way for people to protect themselves is to use condoms and be in a monogamous relationship. Currently, CDC STD treatment guidelines recommend dual therapy with a cephalosporin antibiotic (ceftriaxone is preferred) and either azithromycin or doxycycline to treat all uncomplicated gonococcal infections among adults and adolescents in the United States. In order to delay the inevitable day when standard drugs will no longer work, doctors at the Centers for Disease Control and Prevention have decided to release new treatment guidelines. A drug such as Ciprofloxacin, or Cipro, was used to treat the disease but now has become ineffective. She says that the disease, spread through vaginal, oral and anal sex, can cause a variety of major problems; especially for women who usually have no symptoms. According to the CDC, concentration of gonorrhea cases among poor people has become evident in African Americans in the South. The class of drugs being used now known as cephalosporins are also used to treat serious conditions such as salmonella poisoning and bacterial meningitis, according to Sparling. Over the years, doctors became greatly concerned with the rise of resistant strains of bacteria as antibiotics become overused in both medicine and agriculture.




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