New Antibiotic Sought for Drug-Resistant Gonorrhea

U.S. health officials are recommending the use of a new drug to treat gonorrhea, which has joined a list of "superbugs" that are becoming resistant to standard antibiotics.

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The Centers for Disease Control and Prevention say they can recommend fewer kinds of treatment for gonorrhea. That is the second most common sexually transmitted infection in the United States. Health officials say drugs called fluoroquinolones should no longer be used, and that means there is just one class of drugs remaining to treat the infection.

NPR's Brenda Wilson reports.

BRENDA WILSON: Since 1993, a single dose, just one pill of ciprofloxacin, cipro, and other fluoroquinolones, could knock out a case of gonorrhea. As a consequence, infection rates in the U.S. had been steadily dropping. But gonorrhea has become increasingly resistant to the drug. Dr. John Douglas, the CDC's director of STD prevention, says part of the success in controlling the disease has been the availability of effective treatments even as the organism changed.

Dr. JOHN DOUGLAS (Director of Sexually Transmitted Disease Program, Center for Disease Control): Gonorrhea has proven to be quite efficient at navigating around the drugs we use to combat it. Developing resistance first to penicillin and tetracycline, and most recently to fluoroquinolones.

WILSON: The resistance first cropped up in Hawaii and the Pacific Islands, and then California. In 2000, the CDC began to recommend that it not be used to treat people who acquired their infections in those areas. In 2004, gay men throughout the country were included in that group. Drug-resistant gonorrhea among gay men had exceeded five percent. That's beyond the threshold the CDC advises the doctor to stop using the drug because of resistance.

Dr. DOUGLAS: Today, we're reporting new data, which indicate that this threshold has been exceeded among heterosexuals as well. And we have reached the level of resistance that threatens our ability to treat the disease across the population.

WILSON: Overall in the United States, resistant gonorrhea in heterosexuals and men who have sex with men increased 11-fold - from less than one percent to 11 percent. So the CDC is now recommending that fluoroquinolones no longer be used to treat gonorrhea. That means we're now down to one class of drugs to treat gonorrhea - cephalosporins. Right now, it's mainly available as an injection. According to the Infectious Disease Society, gonorrhea has now joined a list of super bugs.

Its director, Dr. Henry Masur of the National Institutes of Health, says we are not developing drugs fast enough to keep up with resistance.

Dr. HENRY MASUR (Chief, Critical Care Department, National Institutes of Health): Antibiotics are not as profitable for pharmaceutical companies as other drugs that you take for months, years, or a lifetime. Unless we find some way to encourage the development of these drugs, we're going to have a greater and greater problem for more and more organisms. So that whether it's pneumonia, or urinary tract infections, or sexually transmitted diseases, we're going to lose our ability to treat them efficiently. And ultimately, we're going to lose our ability to treat them at all.

WILSON: There's no evidence yet that gonorrhea has become resistant to cephalosporins, but Masur says that doesn't mean it can't happen, since antibiotics are overused in both humans and animals.

Dr. MASUR: There is currently a proposal to market a cephalosporin for animals which is very similar to one of the most effective drugs that we use in humans. We can predict that if this drug gets into the food supply, it will cause resistance that will be transmitted to humans and we will lose yet another drug in our antibiotic armamentarium.

WILSON: In 2005, there were 350,000 cases of gonorrhea reported to the CDC, though health officials say that twice as many people are probably infected with the disease. Gonorrhea often goes undetected; resistant gonorrhea can be even harder to detect.

Brenda Wilson, NPR News.

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