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Gonorrhea on the Path to Becoming Untreatable

JUL 11, 2017 | KRISTI ROSA
New data recently released by the World Health Organization (WHO) are showing that one sexually-transmitted disease is progressively moving closer to becoming untreatable: gonorrhea.

This is not an idle threat. According to WHO, Neisseria gonorrhoeae, the bacteria responsible for the infection, are developing widespread resistance to the antibiotics currently used for treatment. This news not only underscores the need for new antibiotics, but also the need for new, affordable point-of-care diagnostic tests so that individuals can receive diagnosis quicker, and thus, timely treatment.

“The bacteria that cause gonorrhea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them,” Dr. Teodora Wi, Medical Officer, Human Reproduction at WHO, explained in the recent news release.

WHO estimates that a staggering 78 million individuals are infected with gonorrhea on an annual basis, and the number of cases that are resistant to current available antibiotics continue to grow in number, according to the WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP).

For example, according to GASP data, 97% of countries included in the dataset reported widespread resistance to ciprofloxacin between 2009 and 2014. WHO also noted an increased number of cases that were resistant to azithromycin (81%) during that period as well. However, arguably the most startling news is “the emergence of resistance to the current last-resort treatment,” or the extended-spectrum cephalosporins (ESCs), cefixime and ceftriaxone (66%). As of right now, ESCs are the last hope for treating gonorrhea in most countries; however, over 50 countries are reporting resistance to these drugs. In response to these data, WHO updated their treatment recommendations to indicate that doctors should prescribe 2 antibiotics to those who are infected with gonorrhea: azithromycin and an ESC: ceftriaxone.

In their news release, WHO postulated that there may be many factors that contributed to the increase in antibiotic-resistant infections. These include:
  • A decrease in condom use
  • An increase in urbanization and travel
  • Poor infection detection rates
  • Inadequate/failed treatment
Regardless of the reasons, the fact cannot be denied: the bacteria are well on its way to becoming untreatable if something is not done about it soon. Unfortunately, the outlook on the development of new antibiotics is not that promising. In fact, WHO reports that “the research and development pipeline for gonorrhea is relatively empty,” as there are only 3 drug candidates currently in development: solithromycin, zoliflodacin, and geptotidacin.

Big advances in treatment can