WHO Responds to Increasing Antibiotic Resistance in Sexually Transmitted Diseases

The World Health Organization (WHO) has just released new guidelines for treating chlamydia, gonorrhea, and syphilis; three of the most common sexually transmitted infections (STIs) due to the increased threat of antibiotic resistance, according to an official press release.

WHO reports that 131 million people are infected with chlamydia; 78 million with gonorrhea; and 5.6 million with syphilis, annually. The aforementioned sexually transmitted diseases have at least two things in common: they are all caused by bacteria and they can all potentially be cured with the assistance of antibiotics. Due to misuse and overuse of antibiotics, however, there are strains of the diseases that have managed to develop resistance to drug treatments, resulting in widespread public concern.

As with most infections or diseases that remain untreated, these specific sexually transmitted infections can lead to major complications for those individuals who are infected. Women infected with these STIs can develop pelvic inflammatory disease, ectopic pregnancy, miscarriage, stillbirth, and newborn deaths, according to WHO. In both sexes, lack of treatment for gonorrhea and syphilis can result in infertility. In addition, WHO reports that infection by any of the aforementioned STIs can “increase a person’s risk of being infected with HIV two- to three-fold.”

When speaking of this global concern and the new WHO guidelines, Ian Askew, director of Reproductive Health and Research at WHO, said, “Chlamydia, gonorrhea, and syphilis are major public health problems worldwide, affecting millions of peoples’ quality of life, causing serious illness and sometimes death. The new WHO guidelines reinforce the need to treat these STIs with the right antibiotic, at the right dose, and the right time to reduce their spread and improve sexual and reproductive health. To do that, national health services need to monitor the patterns of antibiotic resistance in these infections within their countries.”

WHO noted in a press release that “the new recommendations are based on the latest available evidence on the most effective treatments for these 3 sexually transmitted infections.”

Gonorrhea

Out of the three STIs mentioned, gonorrhea is an infection that has been proven to have developed the strongest amount of resistance to antibiotics. Researchers have already detected different strains of gonorrhea that have developed resistance to all available antibiotics, typically referred to as multidrug-resistant gonorrhea. Gonorrhea is particularly common among individuals between the ages of 15 and 24 years and causes infections within the rectum, genitals, as well as the throat of both men and women, according to the Centers for Disease Control and Prevention (CDC). Due to increased resistance, more cost-effective antibiotics that have been used to treat the infection in the past have been rendered ineffective.

In the new guidelines, WHO recommends that all countries update their treatment guidelines pertaining to gonorrhea to better address antibiotic resistance. They urge countries’ national health authorities to analyze the different strains of gonorrhea that reside within their populations and track “the prevalence of resistance to different antibiotics.” In addition, health officials should use local resistance patterns to advise doctors when it comes to prescribing the most appropriate and effective antibiotic for each infected individual. WHO does not recommend the use of a class of antibiotics called 'quinolones' for treatment.

Syphilis

According to the CDC, syphilis has been called “the great imitator,” due to the fact that it can show a number of different symptoms. The infection is transmitted through direct contact with a syphilis sore during oral, vaginal, or anal sexual intercourse. An infected woman can also transmit the infection to her child during pregnancy, which can result in fetal death. According to the WHO press release, “In 2012, mother-to-child transmission of syphilis resulted in an estimated 143,000 early fetal deaths or stillbirths, 62,000 neonatal deaths, and 44,000 babies being born preterm or with low-birth-weight.”

WHO “strongly recommends” that individuals infected with syphilis should be treated with one dose of benzathine penicillin due to the fact that this injected form of antibiotic has been deemed not only cheaper, but more effective than oral antibiotics. Though the Sixty-ninth World Health Assembly had recognized benzathine penicillin as an “essential medicine” in May 2016, countries who have increased cases of syphilis have reported “stock outs.” In an effort to fix this, WHO aims to identify which countries are experiencing shortages, and in addition, monitor the global availability of the antibiotic. Through this, WHO hopes to “close the gap between national needs and supply of the antibiotic,” according to the press release.

Chlamydia

Chlamydia, like syphilis, can be transmitted through oral, vaginal, or anal sex, according to the CDC. It is also “the most common bacterial STI” and those who are infected with it are at a higher risk for, or frequently co-infected with, gonorrhea. Though there are some symptoms typically associated with the infection such as discharge and “a burning feeling when urinating,” most people do not experience any symptoms at all. Regardless, if left untreated, chlamydia can cause serious long-term damage to a woman’s reproductive system, which makes following the recommendations in the new WHO guidelines even more important.

WHO reminds all individuals that “when used correctly and consistently, condoms are one of the most effective methods of protection against STIs.”