WHO: Gonorrhea on the Brink of Becoming Untreatable

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The World Health Organization said this week that three sexually transmitted diseases (STDs) are rapidly building antibiotic resistance. Of these STDs, gonorrhea is very close to becoming untreatable, WHO experts warn.

On Tuesday, the organization also issued guidelines on how to treat the three conditions. Countries will use the instructions to create their own guidance on treating gonorrhea, chlamydia, and syphilis.

And WHO experts insist that for these conditions antibiotics may not be enough. For instance, gonorrhea currently only responds to two antibiotics if the patient takes them in combination.

But that may not last long, and the bacteria behind the disease could become immune to these two last weapons: azithromycin and ceftriaxone. U.S. public health officials also warned this summer that gonorrhea infections may very soon lack any treatment.

Worldwide, just 56 countries monitor the antibiotic resistance of STDs across their territories. Ten countries have already said that the current gonorrhea treatment has in some cases failed. These countries also reported that upping the number of used drugs helped patients win the battle against the disease.

But about 30 countries say that the current regimen is no longer effective as the bacteria has developed unprecedented resistance to the cure. WHO’s medical officer Dr. Teodora Wi noted that the organization based its guidelines on these alarming reports.

Gonorrhea is on the fast track of developing “high-level” resistance to one of the two drugs, ceftriaxone, Wi said. WHO researchers also advise countries to bar the use of quinolones against gonorrhea.

The group explained that the otherwise effective class of antibiotics no longer works against the disease. According to WHO, dual therapy is better than single drug therapy since it prevents the bacteria from growing more resistance.

The recent guidelines recommend countries with sufficient data on antibiotic resistance to tailor recommendations based on that data. States with no data should recommend a cocktail of ceftriaxone or cefixime and azithromycin.

But in 2012, the Centers for Disease Control and Prevention barred physicians from using cefixime because the bacteria strains in the country are immune to it.

The last time WHO issued similar guidance on all three conditions was 13 years ago. Dr. Wi explained that the group needed time to review all the available data, studies, and experts’ knowledge on the issue first.

Canadian experts with a lifelong experience in gonorrhea resistance, however, think that the new recommendations are “well overdue.” One expert even said that they are far from being “revolutionary.”

“But it is very helpful that they have updated [the guidelines],”

the expert said.

Chlamydia and Syphilis: Recommended Treatment

In chlamydia’s case, the updated version brought no significant changes. But syphilis’ guidance has revealed an underlying issue. Benzathine penicillin is the best course of action for treating syphilis now.

The problem is that there is a global shortage of the drug, and in many countries, it is not readily available. Its alternative, doxycycline, is available but it is not recommended for pregnant women. As a result, if doctors fail to treat a pregnant woman for syphilis she may lose the baby. Plus, the risk of birth defects multiplies.

Dr. Wi decried the situation. She noted that drug makers no longer produce benzathine penicillin simply because it is too cheap.

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