From Our 2012 Archives
Incurable Gonorrhea Threat Forces Drug Change
Shot Now Needed to Cure Common Sexually Transmitted Disease
By Daniel J. DeNoon
Reviewed by Louise Chang, MD
Aug. 10, 2012 -- Gonorrhea just got a little more painful to treat -- but at least it's still treatable.
For now, at least. The common sexually transmitted disease has become resistant to all but one class of antibiotic: the cephalosporins. An alarming worldwide rise in resistance even to these last-ditch drugs raises the specter of untreatable gonorrhea.
To buy time, the CDC this week changed a recommended U.S. treatment. Instead of getting a single Suprax (cefixime) pill, patients now should be treated with a shot of ceftriaxone antibiotic and one of two oral antibiotics (azithromycin or doxycycline).
That's not all. Patients now should return to their health care provider a week later to make sure they're cured. Anyone still infected likely carries drug-resistant gonorrhea and needs further treatment.
"This change is a critical preemptive strike to preserve ... our last proven treatment option," said Kevin Fenton, MD, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "Changing how we treat infections now may buy the time needed to develop new treatment options."
Gonorrhea can very quickly become resistant to antibiotics. In the last decade alone, the bug became resistant to the fluoroquinolone antibiotics that used to cure the disease.
When that happened, the CDC first saw resistant gonorrhea in the western U.S. among gay and bisexual men. Ominously, that same pattern now is being seen for cephalosporins.
About 700,000 Americans carry gonorrhea bacteria. Fewer than half of them know it. Although many men and women have symptoms -- discharge and/or a burning sensation during urination -- many do not. That's why sexually active gay and bisexual men and at-risk women should be tested for gonorrhea (and other STDs) at least once a year.
To avoid gonorrhea:
If you do have gonorrhea symptoms, get treated right away. And a week after treatment, get tested to make sure of a cure.
SOURCES: News release, CDC. CDC, MMWR, Aug. 10, 2012. CDC Gonorrhea Treatment Guidelines, revised Aug. 10, 2012.
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