Gonorrhea treatment showing signs of failing

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Federal health officials warned of new signs that gonorrhea is growing resistant to current treatments, a development more troubling for gay men who face a higher risk of the sexually transmitted disease than other populations.

Findings of a new study from Hawaii prompted the Centers for Disease Control & Prevention to raise a warning flag on Wednesday during its 2016 STD Prevention Conference in downtown Atlanta. The findings showed that the current treatment for gonorrhea – a shot of ceftriaxone and an oral dose of azithromycin – was losing its effectiveness in a cluster of infections in Hawaii.

That’s more troubling than data released in July that showed emerging drug resistance and limited treatment options for gay men at a time when infections among them are on the rise, federal officials said during a press conference Wednesday.

“It seems that in the battle between humans and pathogens, gonorrhea is a formidable opponent,” said Jonathan Mermin (photo), director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD & Tuberculosis Prevention.

“We are seeing troubling signs that treatments are failing us. We may be running out of options for treating gonorrhea,” he added.

Gonorrhea is one of the most common sexually transmitted diseases in the country and it impacts gay men more severely than other populations. The CDC has said about 56 percent of gonorrhea cases in the U.S. are among men and of those, 48 percent are estimated to be gay men. Put another way, men who have sex men face a gonorrhea incidence 17 times greater that seen in heterosexual men and nearly 14 times that seen in women, based on the 2014 STD Surveillance Report.

A gonorrhea infection is also a risk factor for acquiring or transmitting HIV, federal health officials said.

But while health officials are concerned with the effectiveness of the current treatment for gonorrhea, they made it clear Wednesday that there have been no confirmed failures of the CDC-recommended dual treatment in the U.S.

“We do not think there is enough evidence to change our recommendations or increase our doses,” said Gail Bolan, director of CDC’s Division of STD Prevention. “We are just really wanting people to be aware that we are concerned that it is not going in the right direction and will continue to monitor it closely.”

What’s also troubling to federal health officials is that no other highly reliable, widely available and affordable backup options exist for treating gonorrhea. But they pointed to encouraging results from early clinical trials of ETX0914, an oral antibiotic, in a study at the Louisiana State University Health Sciences Center.

The novel antibiotic – it would be the first in a new class antibiotics – has proven to be “safe and effective” in treating gonorrhea so far, according to Stephanie Taylor, a professor of medicine and microbiology at LSU and the trial’s lead investigator.

“The thing that is different about this antibiotic and that we are really pleased with is that it has a different method of killing the organism,” Taylor said.

“It would be a brand new class of antibiotics. There are none on the market right now with this mechanism of action,” she added.

Mermin encouraged healthcare providers to fully implement the CDC’s treatment guidelines, including prompt treatment, and researchers and pharmaceutical companies to develop new treatments for gonorrhea.

“In Hawaii, the system worked,” Mermin said in a prepared statement. “Front-line providers diagnosed and treated infections, public health officials quickly detected resistance, and we were able to use cutting-edge lab technologies to track its spread and treat people who were linked to the cluster. A strong STD prevention and control infrastructure is critical to ensure we’re ready to confront drug resistance not just in Hawaii, but nationwide.”


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