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Gonorrhea becoming ‘much harder, and sometimes impossible’ to treat

  • Gonorrhea is becoming harder to treat due to antibiotic resistance, the World Health Organization warned
  • Development of new drugs "not very attractive" to big pharmaceutical firms, the organization said
  • Centers for Disease Control and Prevention says fewer than half of gonorrhea cases detected due to lack of symptoms

Gonorrhea is becoming harder to treat due to antibiotic resistance, health professionals at the World Health Organization have warned.

The WHO issued a warning on Friday saying that the bacteria causing the sexually transmitted infection (STI) are increasingly evolving to resist treatment via antibiotics.

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"The bacteria that cause gonorrhea are particularly smart," Dr Teodora Wi, human reproduction specialist at the WHO, said in a statement on Friday. "Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them."

High-income countries in particular are struggling to treat some cases of the STI , the WHO said. "These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhea is actually more common," Dr Wi added.

The organization estimates that 78 million people are infected with gonorrhea each year. The STI can infect the genitals, rectum and throat – and women are disproportionately affected, it said. It increases the risk of pelvic inflammatory disease, ectopic pregnancy and infertility in women.

It identified three specific antibiotics as being unsuccessful in treating drug-resistant strains of the infection. 97 percent of the countries it monitors for trends in drug-resistant gonorrhea reported widespread resistance to the antibiotic ciprofloxacin; 81 percent reported resistance to the drug azithromycin; and 66 percent reported the emergence of resistance to last-resort treatment.

Making new drugs 'not attractive' to big pharma firms

The WHO has called for the development of new antibiotics to fight back against the 'superbug' – but it is concerned that such development is not attractive for commercial pharmaceutical companies.

"To address the pressing need for new treatments for gonorrhea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline," Dr Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership said. "In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use"

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"Any new treatment developed should be accessible to everyone who needs it, while ensuring it's used appropriately, so that drug resistance is slowed as much as possible," Dr Balasegaram added.

STI 'stigma' making gonorrhea hard to control

Controlling the infection has been complicated by a lack of public awareness, lack of training of health professionals, and a stigma surrounding STIs, the WHO said.

It added that inappropriate use of antibiotics was counterproductive to overall treatment, increasing the development of antibiotic resistance in gonorrhea and other bacterial diseases.

"To control gonorrhea, we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures," said Dr Marc Sprenger, director of antimicrobial resistance at the WHO.

"Specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests – ideally, ones that can predict which antibiotics will work on that particular infection – and longer term, a vaccine to prevent gonorrhea."

The Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia.
Tami Chappell | Reuters
The Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia.

The Centers for Disease Control and Prevention (CDC) in the U.S. estimates that more than 800,000 new cases of gonorrhea occur each year. Fewer than half of the cases are detected and reported due to a lack of symptoms, it said in an educational video in May.

"Medication to treat gonorrhea has been around for decades but the bacteria has grown resistant to nearly every drug ever used to treat it," it said. "Today we are down to one last recommended treatment option – dual treatment with an injection of ceftriaxone and an oral dose of azithromycin. Little now stands between us and untreatable gonorrhea."

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