Over the years, an article comes out that a disease, once easily treated with standard antibiotics, becomes no longer effective and a new standard for treatment is created. On Thursday, it appears to have happened again as federal health officials took steps to head off the emergence of a new gonorrhea “superbug” that’s resistant to standard antibiotics.
Gonorrhea is a sexually transmitted disease that affects 700,000 Americans a year. The disease has finally become resistant to antibiotics except for one particular class and that could soon become ineffective, federal health officials warned. In order to delay the inevitable day when standard drugs will no longer work, doctors at the Centers for Disease Control and Prevention have decided to release new treatment guidelines.
According to the new guidelines, it is telling doctors to hold off on a potent oral antibiotic, which is now being used to treat the infection. The guidelines now dictate to doctors to use an injectable form because it appears that the gonorrhea bacteria seem less likely to develop resistance.
At the same time, a second type of antibiotic pills will also be given. According to Kimberly Workowski, an infectious-disease expert at the Emory University School of Medicine in Atlanta, she says, “Gonorrhea for years has developed resistance to every antibiotic we’ve thrown at it.”
“We’re at the end of the line on standard therapies,” comments professor of medicine at the University of North Carolina-Chapel Hill’s P. Frederick Sparling.
According to the CDC, the dangers of gonorrhea range from being a major cause of infertility among women to increasing the risk of being infected with HIV, the virus that causes AIDS, and that they will spread it to their partners. If this wasn’t bad enough, treatment for gonorrhea, which was easy to treat as recently as 2007, has become increasingly difficult. A drug such as Ciprofloxacin, or Cipro, was used to treat the disease but now has become ineffective. The class of drugs being used now known as cephalosporins are also used to treat serious conditions such as salmonella poisoning and bacterial meningitis, according to Sparling. He also says that these antibiotics may not be useful for much longer.
Carlos del Rio, a physician on the board of directors for the Infectious Diseases Society of America, and an author of the new CDC treatment guidelines, talks about how gonorrhea has always been a “canary in the coal mine,” for doctors, because “it picks up resistance very easily.” As early as the 1930’s, the disease became resistant to the first antimicrobial drugs used against it. During the 1940’s, doctors tried using one of the first known antibiotics, penicillin, to fight it. Eventually, the bacteria mutated and caused penicillin to become ineffective. Over the years, doctors became greatly concerned with the rise of resistant strains of bacteria as antibiotics become overused in both medicine and agriculture.
Today, antibiotic resistance has reached the point that doctors need to think very carefully about the drugs they prescribe for common conditions. Judith O’ Donnell, head of infectious diseases at Penn Presbyterian Medical Center in Philadelphia, feels strongly about this and says some examples are sinus infections, urinary tract infections and ear infections.
Del Rio says that “People are dying in hospitals with pneumonias and other diseases that we aren’t able to treat anymore, because we don’t have effective drugs.” He also said that “we desperately need new antibiotics to fight infections. The pharmaceutical industry has very little incentive to do the research and development for an antibiotic that you take for five to 10 days, though, compared to something like a cholesterol drug, that you take for the rest of your life.”
He does note that there is support from the infectious disease society for federal legislation that would provide drug makers with financial incentives if they create new antibiotics.
With concern over incurable or fatal diseases like AIDS in today’s society, many do not realize how serious gonorrhea is when contracted. Susan Philip, director of STD prevention and control services at the San Francisco Department of Public Health, comments on the harsh reality for women who contract gonorrhea. She says that the disease, spread through vaginal, oral and anal sex, can cause a variety of major problems; especially for women who usually have no symptoms.
The disease increases the chance of contracting a dangerous condition called ectopic pregnancy. What happens is a fertilized egg will not plant in the uterus but the fallopian tubes instead.
Another disease that can occur is called pelvic inflammatory disease that can lead to infertility. Gonorrhea can also harm newborn children in untreated mothers, although it rarely happens in developed countries such as the USA.
Workowski says this because women and babies here receive preventive screening and care. She also adds the best way for people to protect themselves is to use condoms and be in a monogamous relationship. According to the CDC, concentration of gonorrhea cases among poor people has become evident in African Americans in the South. Infection rates are 30% higher in Mississippi than in Wyoming.
Growing Threat of Multidrug-Resistant Gonorrhea
Since antibiotics were first used for treatment of gonorrhea, the organism has progressively developed resistance to the sulfa drugs prescribed to treat it. Currently, CDC STD treatment guidelines recommend dual therapy with a cephalosporin antibiotic (ceftriaxone is preferred) and either azithromycin or doxycycline to treat all uncomplicated gonococcal infections among adults and adolescents in the United States.